摘要
以感觉神经单纤维传入放电为指标,观察由兔腹壁移转至小腿的岛状皮瓣于植入隐神经后的感觉功能重建情况。结果表明,放电均发生在皮瓣范围以内,且多在其中央区域,与植入神经的行径一致,但小阈值刺激放电纤维出现率仍低于正常皮肤。未植神经的对照皮瓣内放电发生率甚少。另报告8例10个手指植入前臂外侧皮神经共11条,植入层次为手指掌侧皮肤或皮瓣的真皮层下。随访时间为97～924天,效果满意。文中对实验结果和感觉恢复过程等问题进行了讨论。
Taking the afferent sensory fiber discharges as an indicator,re-establishment of sensation of the abdominal island flap was investigated in rabbits,The flap,being fed by the superfi- cial epigastric artery,was transplanted to the leg,and the saphenous nerve was implanted into it.The restoration of flap sensation was studied neuroelectrophysiologically.It was shown that nerve fiber discharges were detected within the boundary of the flaps,and mainly in the central portion of the flap along the course of the implanted nerve,in the nerve implanta- tion animals.There was definite evidence of re-establishment of tactile,pressure,pain and tem- perature sensations in the flap,except that the unit discharges evoked by lower threshold sti- mulation were less than normal. In the flaps without nerve implantation nerve fiber discharge was rare,and pain and tem- perature sensation discharges could not be recorded. In 8 patients,nerve implantation was done in an attempt to re-establish sensations in the fingers.Altogether,11 lateral antel rachial cutaneous nerve grafts were implanted to 10 fingers.The longest nerve graft was 9cm.and the shortest 2.5cm.They were implanted under the dermis of the denervated palmar skin of fingers or flaps.The follow-up time was 97-924 days.The results were very satisfactory.
