神经端侧吻合术与侧侧吻合术对神经干损伤后功能恢复作用的比较

Comparion of the function of end-to-side neurorrhaphy and side-to-side neurorrhaphy of peripheral nerves after the trunk damage:an experimental study

目的 比较神经端侧吻合与神经侧侧吻合后功能恢复作用的差异。方法 将Wistar大鼠 18只分成A、B两组 ,每组 9只。端侧吻合组 :左侧腓总神经切断并在胫神经干上外膜开窗后 ,与胫神经主干作端侧吻合 ;侧侧吻合组 :左侧腓总神经切断后与胫神经作侧侧吻合。术后 3个月 ,行形态学检查、电生理检查、肌湿重检查及图像分析 ,评价神经再生及肌肉功能恢复的情况。结果 神经端侧吻合组和神经侧侧吻合组神经纤维的数目分别为 73 2 .8± 5 3 .4、712 .5± 5 8.4,其截面积分别为 (712 .5± 5 8.4) μm2 、(182 .3± 3 9.7) μm2 ,神经的传导速度分别为 (2 5 .6± 8.3 )m /s、(18.5± 9.8)m/s ,胫前肌肉的湿重两组分别为 (2 0 5 .6± 2 0 .7)mg、(2 0 1.8± 2 1.3 )mg ,肌纤维的面积分别为 (13 2 0 .6± 10 3 .9) μm2 、(14 0 3 .7± 13 8.4) μm2 ,再生的运动终板面积分别为 (15 3 7.5±5 2 7.8) μm2 、(1774.2± 45 8.7) μm2 ,吸光度值为 0 .42± 0 .15、0 .5 5± 0 .17,所有测量值差异无显著性 (P <0 .0 5 )。

Objective To evaluate the functional recovery of end to side neurorrhaphy and side to side neurorrhaphy. Methods 18 rats were randomly divided into group A and group B, with 9 rats each. The left common peroneal nerve was transected. In group A, The left common peroneal nerve was repaired in an end to side coaption; in group B,the left common peroneal nerve was sutured in paralell with the tibial nerve with fenestration on the tibial nerve. Electrophsiological examination ,muscle wet weight measurement , histological examination and image analyse were used to evaluate nerve regeneration and motor end plates of end to side neurorrhaphy and side to side neurorrhaphy at 3 months postoperatively. Results The number of myelinated nerve was 732.8±53.4,712.5±58.4,and area of myelinated nerve was (712.5±58.4) μm 2,(182.3±39.7) μm 2, the nerve conduct velocity was (25.6± 8.3 ) m/s,(18.5±9.8) m/s, the muscle wet weight was (205.6±20.7) mg,(201.8±21.3)mg,the cross section area of muscle fiber was (1 320.6±103.9) μm 2 ,(1 403.7±138.4) μm 2,areas of motor end plates was (1 537.5±527.8) μm 2,(1 774.2±458.7) μm 2,the light density was 0.42±0.15, 0.55 ±0.17.All values showed no significant difference between group A and group B( P >0.05). Conclusion Functional recovery of end to side neurorrhaphy and side to side neurorrhaphy was not different.