失神经皮瓣移植术后感觉神经再生的研究

SENSORY NERVE REGENERATION AFTER IMPLANTATION OF FREE SKIN FLAP:AN ANIMAL EXPERIMENTAL STUDY

目的 :通过动物实验 ,观察无神经支配的皮瓣移植术后感觉神经有无再生及其再生规律。方法 :以大白鼠为实验材料 ,作右下腹腹壁皮瓣切除手术 ,原位缝合 ,随机分成四组 :分别于术后 1月、2月、3月取材作皮瓣组织切片 ,用改良Bielschowsky银染法及抗NF抗体 ,抗S - 10 0作一抗的免疫组化方法染色观察术后不同时期及正常皮瓣内感觉神经末梢再生的情况。结果 :术后 1月神经末梢短小、零乱、稀少 ,均数为 0 .32条 /mm(免疫组化S - 10 0抗体 ) ,0 .30条 /mm(免疫组化NF抗体 ) 0 .4 3条 /mm(银染 ) ;术后 2月 ,稀疏零乱的神经渐渐增长 ,呈短弧形、密度略有增加 ,平均数分别为 0 .72条 /mm ,0 .74条 /mm ,0 .81条 /mm ,术后 3月神经末梢密度增加 ,短弧形变成长弧形、长丝状、其长度接近正常 ,密度与正常比似乎略有差异。平均数分别为 1.32条 /mm ,1.2 5条 /mm ,1.2 0条 /mm。对照组大白鼠腹壁皮瓣神经末梢平均数为 1.35条 /mm。结论 :失神经皮瓣移植术后感觉神经末梢可以再生 ,其再生一般从边缘开始向中央生长、再生速度为 1mm/ 10d 。

Objective:To observe whether the sensory nerve can regenerate.Methods:Twenty-one SD rats were divided into group A (control group),group B,group C and group D.All the rats were performed a free skin flaps implantation and observed in the first month,the second month and the third month after operation by immunohistochemistry.Results:The regenerated nerves were short,in great disorder and rare in the first month,and the nerve mean were 0.32/mm(S-100),0.30/mm(NF) and 0.43/mm(silver staining).The nerves in the second month were better than the first in length,form and order.The mean of the sensory nerve were 0.72/mm,0.74/mm and 0.81/mm.In the third month after operation,the nerves were the same as common in length and the mean were 1.32/mm,1.25/mm and 1.20/mm.The mean of nerve in group A were 1.35/mm.Conclusion:The sensory nerve may regenerate after free skin implantation.It shows that the regeneration process occurres from the border to the central of flap in 1mm/10 day velocity which is related to size and thickness of the flap.