单、双神经植入使肌肉恢复神经支配的实验研究及临床应用

An Experimental Study on Reinnervation of Denervated Muscles Between Dual and Single Nerve Implantaton and Clinical Application

用单、双神经植入失神经肌不同部位,比较神经植入的数量与植入部位对肌肉功能重建的影响。肌电图、肌重、肌力及组织学、组织化学、透射电镜的观察测定证明:原运动终板失去神经后,不植入神经,8周时已失去正常形态,并无神经轴突与肌纤维连接。双神经植入后4周,两根神经均与肌纤维产生了新的终末连接结构,能使较多的肌纤维恢复支配,有比单神经植入更完善的肌电图及肌力的恢复。观察到神经轴突肌肉内生长过程及新生终板的形态,发现新生终板具有正常终板的超微结构特征。临床采用游离腓肠肌移植重建前臂屈肌功能6例,疗效满意。

The purpose of this study was to compare the results of reinnervation between dual and single motor nerve implantion into different sites of the denervated muscles. The weight, EMG, contraction power, motor endplate staining and ultrastructure of the reinnervated muscles were investigated. The result showed that the dual nerve implantation was superior to that of the single nerve implantation, but there was no significant differnee between the original nerve entrance and the ectopic nerve implantation groups. From June 1988 to Dec 1989, we implanted dual and mutiple motor nerves into transplantaed muscles or denervated muscles in 6 patients, all of them recovered satisfactorily