应用神经延长架延长兔坐骨神经的实验研究

An experimental study of rabbits sciatic nerve distracting lengthening with nerve lengthening device for repair of peripheral nerve injury

目的 利用神经延长器延长周围神经 ,修复周围神经缺损 ,为临床应用提供依据。方法 利用自制的神经延长架 ,每天分数次延长 1mm ,修复神经缺损 10mm ,9周后行电生理及组织学观察。结果 延长段神经外膜血供基本正常 ,神经缺损修复后其神经刺激阈值与神经原位缝合组差异无显著性 ,与神经移植组差异有显著性 ,组织学观察 ,延长组和原位缝合组有基本正常组织结构 ,神经移植组有明显空泡变性 ,髓鞘凝固变性。结论 应用神经延长装置 ,采用合适的连接方法 ,可有效的延长周围神经 。

Objective Using a nerve lengthening apparatus to distract nerve for repair of peripheral nerve injury and to provide a basis for clinical application Methods 30 health domestic rabbits were divided into 4 groups.Group A,the injuried nerve was distracted;Group B,nerve was transpanted in primary position;Group C,anastomosis had been performed in between the cut nerve endings in primary position;Group D,branch of sciatic nerve was cut down.After 9 weeks of operation,electron physiological examination,histology observation and nerve fibre count were performed.Results Perineurium blood supply of lengthened nerve segment was almost normal.After repair of the injured nerve,the stimulation threshold value,showed no difference between Group A and Group B (P>0.05),but there was a difference between Group A and Group D (P<0.05),and there was a significant difference between Group A and Group C (P<0.01).Under optic microscope and electron microscope,it was found that there was an almost normal structure in Group A and Group C and there was a significant vacuole degeneration and myelin sheath coagulation degeneration.Conclusion Using nerve lengthening apparatus and suitable method of approximation,effective sciatic nerve lengthening can be done.After anastomosis,the injured nerve can be repaired.This study provides a new method of repairing nerve injury.