反式端侧缝合寄养对大鼠失神经骨骼肌的保护作用

Nerve baby-sitter in reverse end-to-side neurorrhaphy preserves the structure of denervated muscle in rats

目的:感觉神经寄养可以延缓失神经骨骼肌的萎缩,但传统的端端缝合寄养方式需切断供体神经远端而影响再生神经长入。本研究探讨反式端侧缝合寄养对大鼠失神经骨骼肌的保护作用。方法:雌性SD大鼠12只,随机分为反式端侧缝合组(n=6)和对照组(n=6)。切断胫神经,缝扎近端、远端断端。反式端侧缝合组切断腓肠神经,在靠近胫神经进入腓肠肌的胫神经外膜上开窗,腓肠神经近断端以反式端侧缝合于胫神经开窗处。对照组只结扎胫神经近、远端断端。术后12周测量腓肠肌湿重、肌纤维横截面积、运动终板周径。结果:反式端侧缝合组腓肠肌湿重恢复率(39.2%±6.8%)明显优于对照组(19.5%±4.3%),差异有统计学意义(P<0.05)。光镜下对照组腓肠肌大面积萎缩,周围明显纤维化;反式端侧缝合组腓肠肌萎缩不明显,肌纤维结构排列紧密完整,周围少量纤维化。反式端侧缝合组腓肠肌的平均横截面积、运动终板平均周径均显著大于对照组[(1 148.85±547.18)μm2vs.(575.05±140.51)μm2,(102.84±53.29)μm vs.(59.60±26.71)μm],两组差异有统计学意义(P<0.05)。结论:感觉神经反式端侧缝合寄养可以保护大鼠失神经骨骼肌的结构。

Objective： To explore the protected effect of sensory baby-sitter in reverse end-to-side fashion on denervated muscle. Methods： The tibial nerve of twelve female adult Sprague Dawley rats was transected. Six animals served as controls. In the other rats,the end of the sural nerve was connected to the side of the distal tibial nerve stump. After twelve weeks,the wet weight,cross-sectional area,motor endplate perimeter from gastrocnemius muscle were examined. Results： The difference in wet weight between the experimental group and the control group was statistically significant（39. 2% ± 6. 8% vs.19. 5% ± 4. 3%,P 0. 05）. Histological observation of the unprotected muscles displayed wide areas of atrophied fibers and considerable connective tissue hyperplasia,whereas the structure of the experimental rats was preserved and there was only a slight increase in connective tissue. The average cross-sectional area and motor endplate perimeter of muscle fibers were significantly larger in the experimental group than in the control group [（1 148. 85 ± 547. 18） μm2vs.（575. 05 ± 140. 51） μm2,（102.84 ±53.29） μm vs.（59. 60 ± 26. 71） μm,respectively]. Conclusion： Sensory baby-sitter in reverse end-to-side neurorrhaphy preserves the structure of denervated muscle in rats.