周围神经卡压松解后病理生理变化的实验研究

EXPERIMENTAL STUDY OF PATHOPHYSIOLOGICAL CHANGES FOR PERIPHERAL NERVE AFTER NEUROLYSIS

目的 应用神经特殊染色技术及电生理学方法 ,探讨周围神经卡压松解后神经纤维的再生修复和神经传导功能的变化。方法 在大鼠坐骨神经卡压模型基础上 ,将 6 0只 SD成年雄性大鼠随机等分为四组。A组 :仅去除卡压 ;B组 :去除卡压后切开神经外膜 ;C组 :去除卡压后神经外膜下周围注射利美达松 (0 .5 m g/ kg) ;D组 :去除卡压后切开神经外膜 ,然后在神经周围注射利美达松 (0 .5 mg/ kg)。于去除卡压后 1、2、3、4和 5周行运动神经传导速度 (MNCV)及潜伏期 (L an)检测 ,定期取材进行组织学观察。结果 神经卡压松解后 2周 ,各组 MNCV及 L an均有明显恢复 ,至第 5周 ,C、D组电生理变化明显优于 A、B组 ,其中 C组恢复最明显 (P<0 .0 5 ) ,而 A与 B组相比 ,无统计学差异 (P>0 .0 5 )。组织学观察到卡压松解后 3周 ,C、D组均可见大量再生神经纤维。结论 卡压去除后可明显改善神经传导功能 ,而松解后神经周围给予利美达松有助于损伤神经的结构再生和功能恢复。

Objective To investigate the changes of regeneration and conduction function for peripheral nerve after neurolysis by nerve special staining and electrophysiology. Methods Sixty Sprague-Dawley male rats were randomly divided into four groups( n =15), four methods were designed on rats models of sciatic nerve compression. There were simple decompression as group A, internal neurolysis after decompression as group B,lemithason(0.5 mg/kg) injected in the epineurium after decompression as group C, and lemithason(0.5 mg/kg) injected around the epineurium after decompression and internal neurolysis as group D.Motor nerve conduction velocity(MNCV) and motor latency (Lan) were monitored at 1,2,3,4,5 weeks after decompression,sections were regularly taken from the previously compressed area to perform morphometric analysis. Results After 2 weeks of decompression,the significant recovery were observed in both MNCV and Lan of four groups.Up to the 5th week of decompression,recovery of electrophysiology was significantly faster in group C and D than that of group A and B, particular in group C( P <0.05), while group A compared with group B,there was no statitical difference in both MNCV and Lan( P >0.05).Morphometric analysis showed that a lot of neural regeneration fibers were observed in group C and D after 3 weeks of decompression. Conclusion Decompression can improve nerve conduction function significantly,while injection of lemithason in epineurium after decompression can promote the structure and function recovery of injured nerve.