猕猴舌下-舌神经移位移植的电生理研究

ELECTROPHYSIOLOGICAL STUDY OF HYPOGLOSSAL LINGUAL NERVE TRANSFER OF MACACA MULATTA

目的：对再造舌肌肉电生理和剩余舌肌动力性恢复的研究。方法：本文通过猕猴动物实验，采用自身对比设计，对舌下神经与舌神经移位移植进行了电生理研究。结果：（１）神经传导速度随时间延长不断恢复；术后３、６、１２月其恢复率分别为：舌前份５０．８３％，７３．８７％，８２．７９％，舌中份７７．９６％，９６．６０％，９２．３４％，术后６月神经传导速度基本上恢复可正常范围内，舌前份为２．２０ｍ／ｓ，舌中份３．５６ｍ／ｓ；（２）对照侧动作电位幅度：舌前份＞舌中份。（３）神经移位移植术后３，６，１２月中实验侧动作电位幅度也随时间延长呈不断恢复趋势；（４）对照侧与实验侧之间无运动神经交叉支配。结论：电生理检测提示舌剩余肌动力性可以重建电生理检测技术不失为评价周围神经再生的一种有效的方法。

Objective:To study dynamic reconstruction of residental tongue muscular. Method:Electrophysiological method. There is a sequential recovery of motor nerve conduct velocity follow the time passing. Results: The recovery ratio of 3,6,12 months are 50.83%,73.87%,82.79% of anterior tongue. 77.96%,90.60%,92.34% of middle tongue post operatively. Motor nerve conduct velocity recoved to near normal level 6 months post operatively as 2.20m/s of anterior tongue, 3.56 m/s of middle tongue. Control sides electrokinetic potential range (EPR):EPR of anterior tongue is bigger than that of middle tongue. Mean EPR value's ratio between control group and expermental group is 9.83:8.54,6.21:4.59 separately. There is EPR recovery after nerve transfer. The recovery ratio is 28.20%,55.19% and 83.87% of anterior tongue. 44.96%, 62.58% and 55.48% of middle tongue at separtely 3,6,12 months after surgery. There is no motor nerve enervation and conduction between studied group and controls. These electrophysiologic detecting is an available means to confirm peripheral nerve regeneration. Conclusion: Electrophysiologic measurement of hypoglossal lingual nerve transfer in MacacaMulatta suggest dynamic reconstruction of residual tongue muscular be possible.