再支配的方法及时间对早期失神经支配兔颈阔肌的影响

The effect of different reinnervation times and methods on denervated rabbit platysma

目的比较神经离断后的不同时间采用吻合、植入两种再支配方法的术后效果及每种方法在不同时限的效果。方法将24只新西兰大白兔随机平均分为A、B两组。A组采用植入法,B组采用端端吻合法;每组分别以1、3、5、7个月再支配时间又分为四个亚组,每个亚组3只白兔,6侧神经。切断各组白兔的面神经颈支后,行神经再支配,并于术前和术后2个月在光镜下行大体、组织学观察及神经肌肉电生理指标的检测。结果实验设计时限内,A、B两组术后2个月刺激颈支均可引起颈阔肌的收缩。颈支离断1个月及3个月时行再支配,其电生理指标显示吻合法优于植入法(P<0.05);5个月时两种手术方法的差异无统计学意义(P>0.05);7个月时植入法优于吻合法(P<0.05)。结论A、B两组在不同时间其修复效果有差异,且修复越早亚组的指标越接近正常。

Objective To compare the results of two reinnervation methods which are end- to- end anastomosis and implantation at the same time, and the results of a single reinnervated surgery method at different times using denervated rabbit platysma. Methods Twenty - four New Zealand rabbits were equally divided into groups A andB, and end- to- end anastomosis wasusded in group A, while implantation was used in group B. Each group was divided into 4 subgroups based on differing times of reinnervation surgery （1, 3, 5, 7 months）, and each subgroup contained 3 animals, and 6 samples. The cervical branch of each subgroup animal was transected and the corresponding reinnervation surgery method was perfromed at the corresponding time. Gross observation and morphologic observation of the platysma were arried out along with evaluation of myoneuroelectric activity 2 months after the operation. Results Within the duration of the experiment, all of the platysma contracted in both group A and group B at 2 months postoperatively. When the cervical branch was damaged at 1 month and 3 months, end - to- end anastomosis was better than implantation. For the 5 months group, there was not much differeace between the two methods. For the 7 months group, implantation was better than end- to - end anastomosis, and the mean difference was significant at the 0.05 level. Comparisonm of A and B groups showed that there were discrepancies in results which were dependent on the time interval between injury and surgery. Conclsion The effect of reinnervation in groups A and B was different. In addition, in all groups, the earlier reinnervation tehniques were applied, the better the recovery.