摘要
目的探讨运动神经移位寄养和不同寄养时间对回植后神经根神经再生的影响。方法SD大鼠24只经颈后路制作臂丛根性撕脱伤模型，做颈后路切口约3cm剥离双侧脊旁肌，咬除双侧椎板显露并撕脱左侧C5-7，神经根，再将C6神经前根回植入脊髓前外侧，然后经前路做一沿臂丛走向切口约3cm显露臂丛及肌皮神经，将其他加入肌皮神经及从C。发出到其他的分支切断，使回植C6与肌皮神经单一联系，并将胸内侧神经1分支与肌皮神经端侧缝合神经寄养。将24只大鼠按随机数字表法分为两组，每组12只。（1）运动神经持续寄养组（A组）：持续寄养胸内侧神经3个月。（2）运动神经非持续寄养组（B组）：于术后1个月再次经前路手术结束胸内侧神经寄养。术后两组各在2，3个月时相点行电生理（诱发电位）、肌肉湿重、肌肉纤维截面积检测。结果术后2，3个月，肌肉运动诱发电位恢复率B组分别为（30．1±4．2）％、（54．8±9．6）％，A组分别为（12．2±3．3）％、（15．1±3．5）％（P〈0．01）。肌肉湿重恢复率13组分别为（76．4±7．3）％、（94．3±4．4）％，A组分别为（75．9±5．3）％、（92．7±8．6）％；肌肉纤维横截面积恢复率B组分别为（76．9±6．7）％、（92．9±3．5）％，A组分别为（74．4±5．5）％、（88．5±7．5）％。B组恢复率均稍优于A组（P〉0．05）。结论运动神经端侧寄养早期能促进回植后脊髓神经根对骨骼肌再支配，持续寄养则抑制了回植后脊髓神经根对骨骼肌再支配；非持续寄养（寄养后1个月结束寄养）可获得更好的肌肉运动诱发电位恢复率。
Objective To observe the effect of motor nerve baby-sitting and different baby- sitting stages on nerve regeneration in nerve root re-implantation for brachial plexus avulsion injury. Methods Twenty-four SD rats were used to induce the brachial plexus avulsion injury. C5-7 roots were avulsed and C6 anterior root was re-implanted to the spine cord via a posterior approach. Branches erupting from C6 and the branches affiliated to the musculocutaneous nerve were cut away via an anterior approach. Re-implanted C6 anterior root was connected singly with musculocutaneous nerve. After that, the end of one branch of medial pectoral nerve was sutured to the lateral musculocutaneous nerve. The animal was divided into persistence motor nerve baby-sitting group （Group A, n = 12） and protophase motor nerve baby-sitting group （Group B, n = 12） according to the random number table. Electrophysiological evoked potential, muscle wet weight and muscle fiber cross-sectional area were measured at postoperative 2 and 3 months. Results At postoperative 2 and 3 months, the restoration rates of motor evoked potential in Group A [ （12.2 ±3.3）% and （15.1 ±3.5）% ] revealed significant differences from these in Group B [ （30.1 ±4.2）% and （54.8 ±9.6）% 1 （P 〈0.01 ）, the restoration rates of muscle wet weight in Group A [ （ 75.9 ± 5.3 ） % and （ 92.7 ± 8.6） % 1 were similar with （ 76.4 ±7.3 ） % and （94. 3± 4.4） % in Group B （ P 〉 0.05 ）, and the restoration rates of muscle fibrin cross section area in Group A [ （ 74.4 ± 5.5 ） % and （ 88.5 ± 7.5 ） % ] were similar with （76.9 ± 6.7 ） % and （92.9 ±3.5） % in Group B （ P 〉 0.05 ）. Conclusions Motor nerve end-lateral baby-sitting can improve functional restoration of the skeletal muscle in the early stage after nerve root re-implantation, but prevent functional restoration of skeletal muscle in the late stge. On the contrary, protophase motor nerve babysitting avoid the inhibitory effect in the late stage, which gai
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2016年第8期759-762,共4页
Chinese Journal of Trauma
关键词
臂丛
肌皮神经
神经再生
Brachial plexus
Musculocutaneous nerve
Nerve regeneration
