经皮微球囊压迫术治疗家兔三叉神经痛的组织学研究

Histological study of percutaneous microcapsule compression in the treatment of trigeminal neuralgia in rabbits

目的通过研究经皮穿刺微球囊压迫手术(PBC)治疗三叉神经痛的相关组织学改变,探讨PBC术治疗三叉神经痛的可能原理及机制。方法取30只家兔,随机分为两组,假手术对照组(6只),三叉神经痛+PBC术组(24只)。分别于PBC术治疗1 d、7 d、14 d后及28 d后进行三叉神经节神经组织HE染色、光镜及电镜观察,并测量神经细胞直径。结果正常三叉神经节细胞胞核呈深蓝色、胞质呈紫蓝色,周围主要是中小细胞,中央主要是大细胞,且周边细胞较中央细胞排列紧密。PBC术治疗1 d后三叉神经节的神经细胞及纤维改变不明显,术后7 d、14 d,随时间延长逐渐出现轴突损伤和脱髓鞘,其中通过三叉神经节的神经纤维损伤最为明显,而术后28 d神经纤维损伤及脱髓鞘逐渐恢复正常。PBC术治疗后1 d、7 d、14 d及28 d的神经细胞实际直径均无明显差异(P> 0. 05)。结论PBC术治疗家兔三叉神经痛,术后不同时期出现不同程度的轴突损伤及脱髓鞘改变,为PBC治疗三叉神经痛提供理论基础,并为后续分子研究提供方法学指导。

Objective The possible mechanisms of percutaneous balloon compression(PBC)in the treatment of trigeminal neuralgia by studying the histological changes of PBC were investigated.Methods Forty-eight rabbits were randomly divided into two groups,sham-operated control group,and trigeminal neuralgia+PBC group.HE staining,light microscopy and electron microscopy of trigeminal ganglion nerve tissue were performed at1d,7d,14d and 28d after PBC treatment.And the diameter of nerve cell was measured.Results The nucleus of normal trigeminal ganglion cells was dark blue,and the cytoplasm was purple-blue.The surrounding were mainly small and medium-sized cells,and the central part was mainly large cells.The peripheral cells arranged more tightly than the central cells.After1d of PBC treatment,the changes of nerve cells and fibers in the trigeminal ganglion were not obvious.After7d and14d of PBC treatment,axonal injury and demyelination gradually appeared.After28d of PBC treatment,nerve fiber damage and demyelination gradually returned to normal.There was no significant difference in the diameter of nerve cell at1d,7d,14d and28d after PBC treatment(P>0.05).Conclusion Different degrees of axonal injury and demyelination change occur at different stages after PBC treatment of trigeminal neuralgia in rabbits.It provides a theoretical basis for PBC treatment of trigeminal neuralgia,and provides methodological guidance for subsequent molecular research.