半吻合、半埋入法桥接周围神经缺损的实验研究

Experimental studies on bridging damaged peripheral nerves by semi anastomosis and semi implantation method

目的 :介绍半吻合、半埋入法用骨骼肌桥接周围神经缺损的新方法。方法 :首先于骨骼肌上在选定肌桥的两端各做一“丁”字形切口 ,横切口与肌桥长轴垂直 ,纵切口则与其平行 ,深度以能将神经断端埋入为宜 ,然后 ,将神经远、近端分别埋入相应的两个纵切口内 ,神经断端浅部一半的神经外膜与横切口处的肌外膜对齐 ,并做缘对缘吻合 ,纵切口处的肌外膜彼此吻合。结果 :手术难度降低 ,时间缩短 ,吻合牢靠。神经纤维于肌束间隙、外膜下顺利通过肌桥与远端吻合 ,功能得到恢复。结论 :半吻合、半埋入法是用骨骼肌桥接周围神经缺损的理想的新方法。

Objective: To introduce a new semi anastomosis and semi implantation method for repairing the damaged peripheral nerve with skeletal muscle.Methods: 'T' type incisions were made at both ends of the bridging muscle. The transverse incisions were vertical to the longitudinal axis of bridging muscle, and the longitudinal incisions were parallel to it.The depths of longitudinal incisions should be enough to bury the distal and proximal end of free nerve.Then we brought both edges of the superficial half part of epineurium and epimysium into contact, connected them by anastomosis, finally, sewed up the two edges of epimysia from both longitudinal incisions.Results: It was proved that the operation was easily performed with this new method in less time and the suture is reliable.The new regenerating nerve fiber bundles were found growing beneath the epimysium and toward the distal nerve end in the muscle bundles.Finally, the distal and proximal part of nerve end met each other by anastomosis, and the function of denervated muscles was restored.Conclusions: The semi anastomosis and semi implantation method is proved to be a ideal way to repair the damaged peripheral nerves.