内脏神经-体神经端侧吻合对供体神经及其功能的影响

The effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions

目的 利用神经形态学、肌电图技术检测内脏神经-体神经端侧吻合对供体神经及其功能影响.方法 选用24只成年雄性SD大鼠（230～250 g）随机分成两组：A组：正常对照组（n=12）;B组：端侧吻合组（n=12）.A组仅行L3～L6椎板切除术,B组行左侧腰6前根（L6VR）与腰4前根（L4VR）行端侧吻合.术后4、12、24周检测所有大鼠左侧胫骨前肌肌电图.术后24周处死大鼠取端侧吻合组L4神经吻合口后神经段及正常组大鼠L4神经甲苯胺蓝染色计数神经纤维.测量L4神经支配肌肉胫骨前肌肌肉湿重及苏木素-伊红（HE）染色观察肌肉形态.结果 术后4、12周B组都有不同程度的失神经肌电图改变,24周时已经恢复正常.24周时端侧吻合组左侧吻合口远端L4VR、正常大鼠左侧L4VR神经有髓神经纤维数量分别为（1 043 ±212）、（1 039±205）个,两组比较差异无统计学意义（P＞0.05）,两组肌肉形态比较差异无统计学意义（P＞0.05）,两组肌肉湿重分别为（0.666 ±0.043）g和（0,670±0.050）g,两组比较差异无统计学意义（P＞0.05）.结论 体神经-内脏神经端侧吻合对供体神经无不良影响,对体神经支配肌肉功能无不良影响.

Objective Using neural morphology and electromyography technology to study the effect of end-to-side nerve anastomosis of autonomic nerve to somatic nerve on the donor nerve and its functions.Methods Twenty-four young adult male Sprague-Dawley rats [mean weight （230 ± 28） g] were randomly divided into 2 groups：group A,control group （n =12）;group B,end-to-side anastomosis group （n =12）.In group A only a L3-L6 laminectomy was performed,and in group B the distal end of left L6 ventral root （L6VR） was sutured in an end-to-side fashion to Left L4 ventral root （L6VR）.All rats＇ left tibialis anterior muscle electromyogram （EMG） was recorded at 4th,12th,and 24th week after operation.At 24th week after operation,the rats were sacrificed.The left L4 nerve segment In control group,and the left L4 nerve segment distal to the anastomosis site in end-to-side anastomosis group were resected and stained with toluidine blue for nerve fiber count.The L4 nerve innervated tibialis anterior muscle wet weight was measured,and hematoxylin and eosin （HE） staining was used to observe muscle morphology.Results At 4th and 12th week after operation,the denervation EMG changes to varying degrees were observed,and returned to normal at 24th week.The average number of myelinated axons of the left L4VR at 24th week after operation in end-to-side anastomosis group and control group was 1 043 ± 212 and 1 039 ± 205,respectively.At 24th week there were no significant differences in muscle morphology between the two groups （P 〉 0.05）.The muscle wet weights in two groups were （0.666 ± 0.043） g and （0.670 ± 0.050） g respectively with the difference being not significant between the two groups （P 〉 0.05）.Conclusion End-to-side anastomosis shows no adverse effect on the donor nerve and donor nerve innervated muscle function.