治疗臂丛损伤移位神经的组织化学研究

A histochemical study of the donor nerves for treatment of brachial plexus injuries

研究治疗臂丛撕脱伤中移位神经的组织化学特征,为提高疗效提供依据。方法:取9例活体膈神经、副神经、颈丛神经、第4、第6肋间神经各1段;膈神经共12段,3段为新鲜尸体标本。样本运用Karnovsky-Roots的AchE染色法染色。通过图像分析系统测定样本中神经横截面积,神经纤维总数。结果:膈神经运动神经纤维达2685根,副神经为2142根,颈丛运动支为914根,第4、第6肋间神经(腋前线水平)分别为577和662根。膈神经在运动神经纤维数量和截面积上,均较副神经、颈丛运动支、肋间神经优越(P<0.01)。结论:在常用的移位神经中,膈神经是最为理想的移位神经。

Objective:To investigate the histological characteristics of the donor nerves for treatment of brachial plexus injuries. Methods: Phrenic nerve, accessory nerve, cervical plexus (deep branches), the 4th intercostal nerve and the 6th intercostal nerve (at the anteaxillary level) were studied. The nerve specimens were taken from surgical biopsy or fresh cadavers. The Karnovsky's histochemical technique was employed. Quantitative evaluation was performed on semi-automatic analytic measuring system. The number and cross sectional area of the motor fibers were calculated. Results: The phrenic nerve contains 2685 motor fibers, with the cross sectional area of 103. 85μm2, while the accessory nerve contains 2142 ones, with an area of 96. 45 μm2. The deep branch of cervical plexus contains 914 motor fibers, with a cross sectional area of 78. 8 μm2. The number of motor fibers in the 4th and 6th intercostal nerves is 577 and 662 respectively, while the cross sectional area 68. 48 μm2and 76. 37 μm2. Phrenic nerve is superior to other donor nerves regarding the number and cross sectional area of motor fibers. Conclusions: Phrenic nerve is the idealest donor nerve with regard to the quality of motor fibers.