椎管内外神经根移位整体化治疗臂丛神经根性撕脱伤的实验研究

Spinal nerve root transfer and experimental study on integrative treatment of avulsion injury of brachial plexus root avulsion

目的：研究臂丛神经根性撕脱伤后，椎管内、外神经根移位治疗臂丛神经根性撕脱伤的疗效。方法随机选取SD大鼠60只，随机分为实验组及对照组。实验组采用椎管内C5，C6神经根原位修复及健侧C7神经移位修复C8，T1神经根治疗臂丛根性撕脱伤；对照组为膈神经修复肌皮神经，副神经修复肩胛上神经，健侧C7移位修复C8，T1神经根治疗臂丛根性撕脱伤。术后6个月时取材，进行电生理检测，肌肉湿重的测量，肌肉纤维横截面积的检测，HE染色检测观察肌纤维数量，电镜观察神经纤维数量及神经直径。结果实验组神经损伤修复6个月时，其肌肉湿重、肌肉纤维横截面积、肌肉运动诱发电位恢复率、神经生长情况优于对照组。结论椎管内神经根原位修复及椎管外神经根移位整体化治疗臂丛神经根性撕脱伤，无论从肌肉湿重、还是肌肉纤维横截面积比率，或者肌肉运动诱发电位及再生神经生长情况等方面，都取得了良好的效果。

Objective To study the brachial plexus root avulsion injury, spinal canal, nerve root transfer for treatment of brachial plexus nerve root injury effect of rip. Methods 60 SD rats were randomly selected, were randomly divided into experimental group and control group, the experimental group with intraspinal C5, 6 nerve root in situ remediation and contralateral C7 nerve transfer to repair C8, T1 nerve root in treatment of root avulsion of brachial plexus, the control group for cutaneous nerve to repair muscle phrenic nerve, accessory nerve repair the suprascapular nerve, contralateral C7 transfer to repair C8, T1 nerve root in treatment of root avulsion of brachial plexus. Based on 6 months after operation, were measured by electrophysiological examination, muscle wet weight, the muscle fiber cross sectional area detection, detection of muscle fiber number HE staining, electron microscope was used to observe the nerve fibres and nerve diameter. Results The experimental group of nerve injury and repair at 6 months, the muscle wet weight, the muscle fiber cross sectional area of muscle motor evoked potentials, the recovery rate is better than that of the control group, nerve growth. Conclusion Intradural repair and spinal nerve root and nerve root transposition in the integrative treatment of brachial plexus root avulsion, whether from the muscle wet weight, and muscle fiber cross-sectional area ratio, or muscle motor evoked potentials and regeneration of nerve growth condition and so on, have achieved good results.