摘要
目的 探讨副神经移位膈神经后高位颈髓损伤大鼠膈肌MotionEvokedPotentials(MEP)的特点。方法 健康雄性SD大鼠 6 0只。随机分为 1、2、3、4、5、6月六个时间组。取两侧锁骨下切口 ,钝性分离胸大肌 ,暴露颈7,8及胸1神经根 ,将存在副膈神经的大鼠剔除。取下颈部正中切口 ,于颈6水平游离膈神经 ,锐性切断。在锁骨下水平于副神经主干发出内、外侧支以前切断。然后将副神经近侧断端与膈神经远侧断端用 12～ 0医用无损伤针线缝合外膜。同法进行对侧手术。术后第 1、2、3、4、5、6月各组样本取颈后正中切口 ,切除颈4全椎板充分显露颈髓并于颈3 ,4水平锐性横断。将 1枚EEG电极置于大鼠头颅中线皮下作阳极 ,另 1枚EEG针插入硬腭粘膜下作阴极。采用Reporter型肌电图仪给予单个方波电脉冲刺激 ,将同心圆针电极插入胫前肌证实MEP完全消失。于两侧腋前线肋下缘作切口 ,充分显露该处膈肌腹腔侧。直视下于腋前线第 9肋骨下缘垂直胸壁将同心圆针电极插入膈肌肋部。地线均置于胸骨处。信号经放大后打印记录以备后续分析。同时将 10只正常大鼠于C3 ,4水平横断脊髓并检测膈肌MEP。结果 神经移位后随着时间延长 ,大鼠膈肌MEP潜伏期逐渐缩短 ,波幅逐渐增大。 6个月组MEP波幅为 (6 .35± 0 .5 1)mv ,潜伏期为 (3.4 1± 0 .
Objectives To study the features of the Motion Evoked Potentials(MEP) of the diaphragmata in the rats with upper cervical cord injuries after the transposition of accessory nerve and the reconstruction of phrenic nerve. Methods Sixty adult male rats were randomly divided into six timebased groups, 1, 2, 3, 4, 5, 6 month interval and after the operation with accessory nerve transposition and suturing with phrenic nerve. They were also operated with C 3 laminectomy and the cervical spinal cord transecting at the level of C 3,4 by cervical posterior approach. Each group of rats was stimulated subcutaneously in the skull by electrical pulse wave of single square from the Reporter EEG machine. The abdominal side of diaphragm was exposed. The concentric electrodes were inserted into the diaphragm perpendicular to the chest wall and along the inferior border of ninth rib at the anterior line of axilla. The latent periods and the amplitudes of the MEP in the diaphragm of the rats were recorded and were compared with the normal value, thus the recovery rate was secured. Results After the nerve transposition, the latent periods of the MEP in the diaphragm of the rats were curtailed,while the wave amplitude was enlarged. In the rats of 6 months group, the wave amplitude was (6.35±0.51) mv. There was no significant statistical difference (P>0.05), and the latent period was (3.41±0.36) ms. Conclusions The motion evored potentials study showed that the transposition of accessory nerve reconstructing the phrenic nerve can effectively recover the respiratory function in the rats with upper cervical spinal injuries.
出处
《脊柱外科杂志》
2003年第5期283-285,共3页
Journal of Spinal Surgery
关键词
副神经
膈神经
颈椎
脊髓损伤
诱发电位
accessory nerve
phrenic
cervical
spinal cord injuries
motion evoked potentials
