动脉套入吻合与端侧缝合后周围神经再生的实验研究

Li Zhiyue, Zhao Qun, Zhu Jiakai

Department of Orthopaedic Surgery, Hengyang Central Hospital, Henyang Hunan, PR China.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2004 Nov;18(6):487-9.

OBJECTIVE

To know the possibility of nerve regeneration after artery sleeve anastomosis and end-to-side suture.

METHODS

Seventy-five SD rats were divided into 5 groups. First, the distal end of severed peroneal nerve was sutured end-to-side with artery sleeve anastomosis with normal nerve tibial trunk in groups A, B, C and D. Second, the tibial epineurium at the suture site was not removed in group A; the epineurium at the suture site was removed (windowing) in group B; the distal end of pre-injured peroneal nerve was sutured after 14 days and windowing was done in group C; and the neural growth factor was injected into artery sleeve and windowing was done in group D. While the distal end of severed peroneal nerve was sutured end to side directly with normal nerve tibial trunk and windowing was done in group E. The histological observation was made and the number of nerve fibers was recorded after 4, 8 and 12 weeks of operation.

RESULTS

After 4 weeks, there existed the regeneration of axons and myeline sheaths in groups C, D, E, and no nerve fiber regeneration was seen in group A. After 8 weeks, the regenerating nerve fibers were significantly more in groups C, D and E than in group B and in group E than groups C and D (P<0.05). After 12 weeks, the regenerating nerve fibers were significantly more in groups C,D and E than in group B (P<0.05).

CONCLUSION

End-to-side coaptation with artery sleeve anastomosis is a new valuable method in repair of peripheral nerve injuries.

目的

了解动脉袖套吻合与端侧缝合后神经再生的可能性。

方法

将75只SD大鼠分为5组。首先，A、B、C、D组将切断的腓总神经远端与正常胫神经干行动脉袖套吻合端侧缝合。其次，A组在缝合部位不切除胫神经外膜；B组切除缝合部位的外膜（开窗）；C组在14天后缝合预先损伤的腓总神经远端并进行开窗；D组向动脉袖套内注射神经生长因子并进行开窗。而E组将切断的腓总神经远端直接与正常胫神经干端侧缝合并进行开窗。术后4、8和12周进行组织学观察并记录神经纤维数量。