端侧吻合移植神经重建皮瓣感觉的形态观察

The research on end-to-ide nerve transplantation for morphological recovery of sensory reimmervation in denverved skin flap

目的:探讨感觉神经端侧吻合重建皮瓣感觉的可能性。方法 :用新西兰兔25只 ,将兔的一条耳大神经作为供神经 ,在另侧耳取耳大神经移植体(受神经) ,与供神经作端侧吻合后埋入失神经皮瓣 ,按神经移植体埋入皮瓣后时间分为1、2、4个月3个实验组 ,另设正常皮肤组和未植神经对照组 ,每组动物5只。用抗神经丝抗体免疫组化技术观察神经再生形态和分布 ;用电镜观察再生神经的超微结构。结果 :(1)感觉神经端侧吻合后1个月 ,供神经的轴突即可长入神经移植体(受神经) ,随时间延长 ,再生轴突数量逐渐增多。(2)再生神经纤维的超微结构基本正常。结论 :兔耳大神经端侧吻合植入失神经皮瓣后 ,供神经的轴突能长入神经移植体 ,并最终形成具有功能的感觉未梢。

Objective:To explore the feasibility of functional nerve endings regenerated from the domor nerve following end-to-side neurorrhaphy.Methods:In this study,the rabbit greater auricular nerve transplantation model was used.One greater auricular nerve was dissected,embedded in denervated skin flap,and end-to-side anastomosed to the contralateral twentyfive New Zealand Rabbits were divided into 3 groups based on the time after nerve implantation(1,2,4 months after operation).Normal skin and denerved skin flap without nerve implantation served as control group.Antineurofilament immunohistochemical procedure was performed to visualize the morphology and distribution of regenerated nerves.The ultrastructure of regenerated nerves was observed with electron microscope.Results:(1)After one month in end-to-side neurorrhaphy,the axon in proximal stump grew into the distal implanted nerves,the amount of regenerated axons in distal nerves increased with the time after operation.(2)The ultrastructure of the newly regenerated nerve was similar to that in normal skin.Conclusion:The axonal reinnervation of sensory nerve endings from the proximal stump to distal implanted nerve in end-to-side nerve neurorrhaphy is feasible.