端侧吻合中供体神经的损伤处理促进神经再生作用的研究

Research about the receipient nerve regeneration induced by donor nerve's injury management in end-to-side neurorrhaphy

目的:研究端侧吻合中供体神经对于受体神经再生作用。方法:选用雄性SD大鼠20只,随机分为2组,每组10只,每组后肢共20侧。A组:左侧腓总神经的切断后,同时行在左侧胫神经待吻合口处先开窗后再横向切开一半,后将腓总神经远端以端侧吻合法45°缝合于胫神经开窗处(已横向切开一半处)。B组:除不作供体胫神经的横向切开一半的处理外,其余与A组处理相同。术后2个月行组织学检查,胫神经及腓总神经传导速度检查,腓总神经和胫神经电生理检查,胫前肌肌湿重量,电镜观察再生神经纤维数量。结果:两组肌湿重量无统计学意义(P>0.05),腓总神经的传导速度差异(P<0.05),腓总神经有髓神经纤维计数的差异(P<0.01),A组胫神经传导速度明显小于B组。结论:说明我们对供体神经进行横向切开处理对于神经再生是有必要的,但是对于胫神经的横向切开一半的处理对于胫神经产生了影响,在促进神经再生的同时需要重新对供体神经横向切开的范围进行更深的研究。

Objective Research about the receipient nerve regeneration induced by donor nerve＇s injury management in end-to-side neurorrhaphy. Methods Forty sides of hind limbs of twenty SD male rats were randomly divided into 2 groups：In group A, the peroneal was transected and tibial nerve was resected half horizontly.Distal end of transected peroneal nerve on the left side was sutured to windowed tibial nerve in an end-to-side fashion with 45 angle.In group B, tibial nerve was not transected and the remaining procedures were identical with the above.2 months after operation, histological examination,nerve conduction velocity examination,electro-physiology examination, tibialis anterior muscle wet measurement,electron microscopic examination were performed. Results Wet muscle measurement made no significance （P〉0.05）.The difference of peroneal nerve conduct velocity （P〈0.05）,the number of regenerated peroneal nerve got significant difference （P〈0.01）.The tibia1 nerve＇s conduct velocity in group A was superior to group B. Conclusion The horizontal resection to the donor nerve,which inserts harmful effect on the donor nerve ,is necceseary for the nerve regeneration.Further research will be made to the nerve regeneration on the condition of donor nerve＇s horizontal resection .