大鼠腓总神经“π”式桥接于胫神经再生的原配连接

The original nerve reunion of regenerating axons in peroneal nerve via "π" fashion neurorrhaphy to tibial nerve

目的研究大鼠腓总神经被切断桥接于胫神经后,再生的腓总神经纤维的来源。方法将大鼠右侧腓总神经在胭窝处剪除约5 mm后,将断裂的腓总神经近端和远端分别就近与同侧胫神经上的外膜窗施行端侧吻合,吻合口间距约10 mm;动物存活24个月后,将手术侧近端吻合口以上胫神经剪断,再将辣根过氧化物酶注入远段腓总神经干内,72 h后取材并经四甲基联苯胺显色显示脊髓L_(3-6)节段神经元和L_4、L_5脊神经节细胞,同时取腓总神经远段行电镜观察神经纤维再生状态。结果远段腓总神经再生神经纤维清晰、明显,神经纤维比正常者略细;脊髓L_(3-6)节段和L_4、L_5脊神经节均见到蓝染细胞。结论断裂腓总神经"π"式桥接于胫神经,至少有部分再生神经纤维经腓总神经近段来源于原配神经的胞体。

Objective To explore the origin of the regenerating axons which grow into peroneal nerve after ＂π＂ fashion double end-to-side neurorrhaphy to tibial nerve. Methods The right peroneal nerve of Wistar rats was resected leaving a 5mm long gap defect. The proximal and distal nerve stumps were sutured l cm apart, in an end-to-side fashion like ＂π＂, to the epneurium windows, opened by removing the epineural sheath on the intact tibial nerve trunk with 1 mm long. Twenty-four months after surgery, HRP was injected into peroneal nerve trunk, and before that, proximal segment of tibial nerve was resected about 3mm off. Sevenfy-two hours later, the distal segment of peroneal nerve was removed and super-thin section were observed by electronic microscope. The spinal cord L3.6 and spinal ganglions L4 ,L5 were cut 40μm, 30μm respectively and stained by TMB method. Results Tile morphological study clearly revealed that there were correspondent regenerating axons in the distal peroneal nerve segment, meanwhile in the anterior horn of spinal cord L3.6 and L4, Ls spinal ganglions, a numerous of neurons were found stained blue. Condttsion ＂π＂ fashion neurorrhaphy via double end-to-side suturing to an intact nerve can bridge a gap in nerve continuity.