周围神经小间隙动脉桥接后的组织学观察

A histological observation of nerve regeneration in small gap anastomosis by arterial bridging

目的探讨动脉套管内神经间隙缝合后神经再生的机理。方法在ＳＤ大鼠腓总神经切断后，行外膜直接缝合及用２ｍｍ间隙自体动脉套接作比较。术后７、１４、２１、２８天取两组样本，采用多种染色法染色后，在光镜及电镜下观察神经的再生过程。结果动脉桥接组神经再生时间比直接缝合组慢２周，但再生速度基本相同。动脉套管内神经纤维向远端生长的有效率较直接缝合组大。结论神经缝合段留出供神经自然随机选择及化学特异选择的空隙。

Objective To study the mechanism of nerve regeneration in a gap wrapped by artery segment. Methods After clear cut of the common peroneal nerve (CPN) of SD rats, two anastomosis techniques were used. Group A included the right CPNs in which the nerve stumps were directly sutured in an end to end fashion. Group B included the left CPNs where the stumps were anastomosed in a distance of 2mm gap that was wrapped with an autogenous artery segment 4mm in length. At 7, 14, 21, and 28 days of postoperative intervals, the segments of CPNs at the anastomosing site were harvested and stained by various staining methods. The samples were then observed under light and electron microscope. Results Nerve regeneration was 2 weeks later in artery wrapping group than in direct anastomosis group, but the overall growth rate of axonal regeneration was almost the same. There were more useful nerve fibers regenerated into the distal stump in the artery wrapping group. Conclusions A gap between two nerve ends in repairing of a mixed nerve was beneficial to nerve regeneration in that it is favourable for natural matching and chemotaxis of nerve axons.