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[通过神经纤维微分离技术显示的端侧神经缝合部位的侧支发芽]

[Collateral sprouting at end-to-side neurorrhaphy site demonstrated by nerve fibers micro-tease technique].

作者信息

Zhu Qiangtang, Zhu Jiakai, Lao Zhengguo

机构信息

Department of Orthopedics and Microsurgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou Guangdong, 510080, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2005 Nov;19(11):868-70.

Abstract

OBJECTIVE

To develop a technique that can directly demonstrate collateral sprouting of intact nerve fibers at end-to-side neurorrhaphy site.

METHODS

Five Wistar adult rats were used in this study. The common peroneal nerves at one side were sectioned at the level of knee joint, and their distal ends were sutured to the tibial nerves after removal of a 1 mm-diameter window in the epineurium. Three months after the operation, the nerve segments at neurorrhaphy site and the normal tibial nerves at the contralateral site were harvested. The specimens were fixed in 10% formaldehyde and post-fixed in 1% osmium tetroxide, then macerated in glycerol. Single fiber was teased out in pure glycerol under an operative microscope, then transferred to a slide and observed under light microscope. The nerve segments at neurorrhaphy site and distal peroneal nerves were also harvested for histological evaluation.

RESULTS

At the neurorrhaphy site, small nerve fibers sprouted from a donor nerve fiber near node's of Ranvier. While such phenomena were not found in normal tibial nerve. From the longitudinal section of neurorrhaphy site, bundles of nerve fibers ranged from tibial nerve to peroneal nerve were observed. Lots of regenerative nerve fibers emerged in distal peroneal nerve.

CONCLUSION

The phenomena of collateral sprouting at end-to-side neurorrhaphy site can be demonstrated directly by nerve fiber micro-tease technique.

摘要

目的

开发一种能够直接显示端侧神经缝合部位完整神经纤维侧支发芽的技术。

方法

本研究使用了5只成年Wistar大鼠。将一侧的腓总神经在膝关节水平切断,去除神经外膜上直径1mm的窗口后,将其远端缝合到胫神经上。术后3个月,采集神经缝合部位的神经段和对侧正常的胫神经。标本用10%甲醛固定,再用1%四氧化锇后固定,然后在甘油中浸软。在手术显微镜下在纯甘油中分离出单根纤维,然后转移到载玻片上,在光学显微镜下观察。还采集神经缝合部位的神经段和腓总神经远端进行组织学评估。

结果

在神经缝合部位,在靠近郎飞结的供体神经纤维上有小神经纤维发芽。而在正常胫神经中未发现此类现象。从神经缝合部位的纵切面观察到,有一束束神经纤维从胫神经延伸到腓总神经。腓总神经远端出现大量再生神经纤维。

结论

通过神经纤维显微分离技术可以直接显示端侧神经缝合部位的侧支发芽现象。

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