小儿炎症阑尾肌间神经丛观察

Observation on intermuscular nerve plexus in inflammatory appendix

目的 探讨小儿炎症阑尾壁肌间神经节及节内神经节细胞 (节内细胞 )数量变化 ,形态以及肌间乙酰胆碱酯酶染色纤维的数量变化的意义。方法 应用HE染色对 1～ 13岁 (平均 6 .9岁 )急性单纯性阑尾炎 4 0例 ,急性化脓性阑尾炎 4 7例 ,急性坏疽性阑尾炎 30例及 4 2例对照组进行观察 ,分别取每个标本的尖端、中部、根部三处 ,测定肌间神经节密度 (神经节总数 /周长 )及节内细胞数 ,并对其中各类型阑尾各 6例及对照组 7例的肌间乙酰胆碱酯酶阳性纤维进行观察。结果 炎症阑尾肌间神经节密度及节内细胞数较对照组减少 ,并随炎症的加重而明显减少 ;同一病理类型阑尾炎 ,从根部至尖端两参数亦呈递减趋势 ,而神经节细胞的成熟度无异常。胆碱酯酶阳性纤维也随炎症加重而明显减少。结论 炎症阑尾肌间神经节密度。

Objective To explore the variation and significance in the number and form of myenteric ganglions,ganglion cells and acetylcholinesterase (AchE) positive staining fibers in inflammatory appendix.Methods 117 cases aging from 1 to 13 years (mean 6.9 yrs ) of different type appendicitis were studied.Of them,acute simple appendicitis was in 40,acute suppurative appendicitis in 47 and gangrenous appendicitis 30.Forty two intussuscepted appendices were served as controls.Each appendix specimen was studied by three parts (apex,middle and base).The myenteric ganglions and ganglion cells were examined in quantitative analysis and compared with the controls.The AchE positive staining fibers of 6 cases from each type of appendicitis were counted and compared with 7 cases from the controls.Results The ganglion density and ganglion cell number and AchE positive staining fiber in appendicitis series was less than the normal controls. The former decreased obviously accompanied with the degree of inflammatory appendix.From the base to apex,the ganglion density and ganglion cell number were gradually decreased.The maturation of ganglion cells in all series were in normal.Conclusion The decreasing of the density of myenteric ganglion and number of ganglion cells is closely related to the degree of appendicitis.