神经压榨的股薄肌、肛门外括约肌成形术──动物实验与临床

The Sphincteroplasty Using the Neurotripsied Gracilis Muscle

根据近年来建立的肌肉超神经支配理论，进行动物实验，证明：暂时性失神经状态的骨骼肌可以通过周围肌肉神经再生和自家神经恢复而获双重神经支配；又从平滑肌和骨骼肌肌电相互影响效应，指出重建括约控制功能时两类肌肉直接接触愈着的重要性，从而确立神经压榨股薄肌、肛门外括约肌成形的理论依据。介绍手术重点注意事项。临床上对大便失禁患儿施行该手术治疗１２例，效果明显。

Based on the theory of exporimental super-innervated muscle in animals, an experiment was designed to make a temperary denervated skeletal muscle,in mice.and a model of dualinnervation of the skeletal muscle could be obtained. The functional contraction of the denervated muscle could be produced by the new innervation from the surrounding muscle which reinnervated the denervated muscle from its original nerves. The second group of animal experiments showed that the cross effect between striated and smooth muscles was demonstrated by electromyography. Twelve incontinent patients in whom a rectal pull-through procedure for congenital anorectal atresia was done in childhood came for further repair. Reconstuction of external sphincter was performed using a neurotripoied gracilis musle, with fasia removed and vascular supply preserved, transplanted surround the new anal canal close contact with its smooth muscle wall. The results were encouraging.