副神经移位恢复高位颈髓横断伤大鼠膈肌运动功能的初步研究

Preliminary Study on Accessory Nerve Transfer for Reanimating the Diaphragm in Rats with High Cervical Spinal Cord Transversal Injury

目的 :探讨副神经移位膈神经恢复膈肌运动功能的可行性。方法 :成年雄性SD大鼠 10 0只随机分成A、B2组。经颈前路显露两侧膈神经干 ,于C6水平切断。A组原位缝接 ;B组游离副神经 ,在其主干进入斜方肌前切断 ,并与膈神经干缝接。术前 ;术后 5min及第 1、2、4、6、8个月观察膈肌的位移 ,然后于C3～ 4 水平横断脊髓了解膈肌的位移变化。比较各时间点 2组膈肌位移的恢复率。结果 :高位颈髓横断伤前 2组膈肌位移恢复率无显著性差异 ,而高位颈髓横断伤后B组膈肌位移恢复率明显优于A组。结论 :副神经移位膈神经能有效地恢复高位颈髓横断伤大鼠的膈肌运动功能。

Objective:To explore the effect of accessory nerve transfer to phrenic nerve for reanimating the diaphragm in rats with high cervical spine transversal injury.Method:One hundred rats were divided into A and B groups.Expose and transected bilateral phrenic nerve at C 6 level by the cervical anterior approach.The phrenic nerve of A group rats were directly anastomosed.The accessory nerve of B group rats are exposed,transected and transfered to phrenic nerve when its stern joined into trapezius.After observed the diaphragm action the cervical spinal cord was transversal transected at C 3?4level.Record the diaphragm's translation again then compared the motor function reinstatement between A and B groups before operation and after operation 5 min,1,2,4,6,8 months.Result:Before high cervical cord injury no statistical significant differences were found about diaphragm motion recovery.After high cervical spinal cord was injured there were significant differences comparing the accessory nerve to phrenic nerve transfer for reinstatement of diaphragm's motor function with phrenic nerve direct anastomosed.Conclusion:The accessory nerve transfer to phrenic nerve is an effective means of reanimating the diaphragm in rats with high cervical spinal cord transversal injury.