摘要
目的 探讨急性扩张延长周围神经的合理注水量与延长值。方法 使用组织扩张器对 3组 (每组 8只 )大鼠坐骨神经行一次性扩张延长 ,注水量分别为 3ml、5ml、7ml。分别于注水前、注水后即刻、注水后保持 5min、去水囊后 15min ,进行肌电测定 ;并在光镜、透射电镜下进行组织学观察。结果 (1)延长值 (起始长度均为 1.5cm) :分别为 8.3 3 %、14 .7%、2 0 .4%。 (2 )肌电结果 :3ml、5ml组的运动神经传导速度与复合肌肉电位 (CMAP)的潜伏期 ,神经扩张前和扩张后相比无明显差别。 7ml组则比术前明显减慢及延长。 (3 )轴突密度 :3ml、5ml组扩张部与正常段神经相比无明显差异。 7ml组轴突的密度则明显降低。 (4)形态学 :3ml、5ml组的神经结构基本正常 ,7ml组束膜间有血管扩张、间质水肿、出血及脱髓鞘变化。 (5 )超微结构 :3ml、5ml组神经髓鞘为圆形 ,排列规则 ;7ml组神经髓鞘明显皱缩变形。结论 大鼠坐骨神经一次性扩张延长的合理注水量为 5ml,延长值为 14 .6%。
Objective To investigate the infusion volume and relevant lengthening value of acute expansion for peripheral nerve lengthening. Methods Tissue expander was applied in three groups of rats (8 rats each) to lenthen the sciatic nerve in one step by infusion of 3 ml, 5 ml, or 7 ml water respectively. Electromyographic testing was carried out before infusion, immediately after infusion, 5 minutes after infusion and 15 minutes after removal of the expander. Histological examination under light microscope and eletron microscope was also done. Results The lengthening value (the initial length was 1.5 cm) was 8.33 %, 14.7 %, and 20.4 % in three groups respectively. There was no significant difference of motor nerve conduction velocity and compound muscle action potential (CMAP) latent period before and after nerve expansion in groups of 3 ml infusion volume and 5 ml infusion volume. In the group of 7 ml infusion volume, however, motor nerve conduction velocity was slower and CMAP latent period was delayed after nerve expansion. In groups of 3 ml and 5 ml infusion volume, the axon density, the structure and ultrastructure of the lengthened nerve were almost normal, whilst decreased axon density, interfascicular vessel dilation, interstitial edema and hemorrhage, demyelination, and shrinkage of myelin sheath were observed in the nerves of the group of 7 ml infusion volume. Conclusion The optimal infusion volume for one stage rat sciatic nerve expansion was 5 ml. The nerve lengthenig value was 14.6 %.
出处
《中华手外科杂志》
CSCD
2001年第1期55-57,共3页
Chinese Journal of Hand Surgery
关键词
周围神经
肌电描记术
组织学
组织扩张器
Perpheral nerves
Electromygraphy
Histology,cpmparative
Tissue expander
