端侧缝合后神经再生方式的实验研究

The study of regeneration mode of end-to-side neurorraphy

目的应用组织学与荧光逆行追踪法研究端侧缝合后的神经再生方式.方法雌性SD大鼠,共24只,实验分3组,分别为正常对照组、端端缝合组和端侧缝合组.3个月后,每组取2只,切取缝合口上下0.5cm的神经采用HE染色法进行缝合口形态学检查.另外6只大鼠,作为供体神经的胫神经用0.2% Diamidino Yellow,用作受体神经的腓总神经用0.2% True Blue进行逆行追踪.7～10 d后经灌注取出大鼠L4～L6的DRG与相应的脊髓腰膨大进行荧光显微镜检测.结果组织形态学观察可见端侧缝合组缝合口近端有神经轴突经侧方长入缝合口远端.同时可以看到胫神经的束膜保持一定的连续性.神经逆行追踪法中双标细胞出现在端侧缝合组L4～L6DRG(L4,L5DRG为主)及相应的脊髓腰膨大的切片中;端端缝合组、正常对照组相应部位仅可见单标细胞.端侧缝合组DRG双标细胞以中、小细胞为主.脊髓内以大细胞为主.结论神经端侧缝合后神经的再生方式是侧枝芽生.再生纤维中既有感觉成分又有运动成分.感觉再生以痛觉为主.

Objective To study the regeneration mode of end-to-side neurorraphy by fluroneurotrace and histological method. Methods 24, female, SD rats were divided into 3 groups： normal group, end-to-end group, end-to-side group. 3 months after models were maded, 2 rats were sacrificed in every group , 0.5cm length of coaptation area were achieved and made slices longititudely, then were dyed by HE and examed histologically . The other rats were used for retrograde neurotrace. Tibia nerves were in 0.2% Diamidino Yellow and perosneal nerve were in 0.2% True Blue.7 ～ 10 days later, L4～1.6 DRGs and correspond spinal cord were achieved. 40μm-thinkness slices were observed under the fluromicroscope. Results Regenerated axons of end-to-side neurorraphy group were found from tibia nerves to personeal nerves by histological examination. And the neuroiums of tibia nerve had its continuous. Retrograde neurotrace showed that double labeled cells with TB and DY in L4～L6 DRGs （mainly were L4, L5 ） and in lateral of anterior corner in correspond spinal cord were only found in end-to-side group. Most of double cells in DRG were middle and small cells. And most of double cells in spinal were larger than 50μm. There were no double label cells in end-to-end group and normal group. Conclusion The mode of nerve regeneration in end-to-side neurorrsphy was collateral regeneration. And both motor and sensor fibers were regenerated. Majority of sensor fibers were related to sensation of pain.