神经外膜切开减压对周围神经缺血再灌注损伤的影响

Effect of decompressive epineurial incision on post-ischemia reperfusion injury of peripheral nerves

目的 研究周围神经缺血再灌注损伤后不同时间外膜切开手术后运动神经传导速度的变化 .方法 2 4只周围神经缺血再灌注兔随机分成对照组 ,即刻行神经外膜切开减压组、1wk后神经松解和 4wk后神经松解组进行运动神经传导速度观察 .结果 神经传导的潜伏期、传导速度和肌肉动作电位波幅 ,各实验组均好于对照组 (P<0 .0 5 ) ,其中即刻行外膜切开减压组与对照组及 4wk后松解组比较差异非常显著 (P<0 .0 1) .结论 周围神经缺血与再灌注损伤后如能尽快或急诊行神经外膜切开减压 。

AIM To evaluate the results of surgical treatment for reperfusion injury of periperal nerves performed at various time intervals between the injury and the decompression procedure, by means of electrophysiological examinations. METHODS Twenty four rabbits were randomly divided into four groups, i.e. those who underwent incision of epineurium for decompression immediately after injury, thosewhich had not received any treatment. RESULTS Electrophysiological studies made on all animals with particular reference to the latency, conduction velocity, amplitude of muscle action potential revealed much better results in the study groups as compared with the control group ( P <0.05). Animals which had immediate decompression fared most favourably in comparison with both the controls and those which had neurolosis at 4 weeks ( P <0.01). CONCLUSION It is suggested that surgical decompression for ischemia and reperfusion injury of peripheral nerves would probably result in better functional recovery so long as it is performed at an earlies possible time or as an emergency treatment.