靶器官前神经束交叉吻合治疗难修复的神经疾患临床与实验研究

Clinical and experimental research of the therapeutical effect of cross anastomosis of nerve bundle near the innervated organs

目的: 采用靶器官前神经束交叉吻合术治疗周围和中枢神经损害或疾患造成支配的效应器官功能障碍并评价其治疗效果。方法: 采用靶器官前神经束交叉吻合11种术式, 治疗12类神经系统疾患及其并发症, 包括脊髓空洞症、脊髓圆锥或马尾神经损伤、腰骶神经根损伤、中枢或周围神经损伤等所引起的手足溃疡、骨髓炎、Charcot关节病等, 同时通过动物实验在损伤及修复后的不同时间进行功能和形态学检查。结果: 40处溃疡或骨髓炎中有30处愈合, 有效率为75%, 并且相应肌肉运动、皮肤感觉和关节活动功能得到有效恢复, 动物实验切断神经经过交叉吻合4周后可恢复正常的体感诱发电位, 并在原神经支配区皮肤神经末梢与其胞体之间形成新的通路。结论: 靶器官前神经束交叉吻合术是治疗周围和中枢神经损害或疾患后效应器官功能障碍的有效方法。

Objective:To study the therapeutical effects of anastomosis of nerve in peripheral and central nerve injuries.Method:To treat 12 kinds of nerve system disorders and their complications,we have used 11 kinds of methods to do crossing anastomosis of nerve bundles near the innervated organs.There are included ulcers of hands or feet,osteomylitis,charcot joint,etc,which were caused by disorders of central and peripheral nerves,such as syringomyelia,injuries of conus medullaris,cauda equina,lumbosacral nerve roots and fascial nerve.Then further experiments were studied by functional and morphological methods.Result:30 out of 40 ulcers and osteomylitis were healed(75% effective) with muscular movement,dermal sense and joint motion recovery.4 weeks later,SEP(somatosensory evoked potential) was recovered by anastomosis of nerve in experimental animals.Conclusion:Anastomosis of nerve was an effective method to treat disorders of peripheral and central nerve injuries.