Kelly C J, Augustine C, Rooney B P, Bouchier-Hayes D J
Department of Anatomy, Royal College of Surgeons in Ireland, Dublin.
Eur J Vasc Surg. 1991 Oct;5(5):535-9. doi: 10.1016/s0950-821x(05)80341-x.
This study assesses the changes in the microvasculature of peripheral nerves in acute large vessel ischaemic neuropathy. An animal model of large vessel ligation, producing an ischaemic neuropathy was used: the presence and extent of the neuropathy was documented by clinical examination and nerve conduction studies. The nerve microcirculation, the "vasa nervorum" was examined using casting materials, methyl methacrylate and silicone rubber, which were in turn examined by light microscopy and scanning electron microscopy. In all, ten animals were used, all of whom showed clinical evidence of an ischaemic neuropathy 1 week post-ligation. This ischaemic neuropathy was confirmed by nerve conduction studies. Corrosion casts were produced in five of the ten animals. Examination of these casts showed that all five had an area of underfilling of the microcirculation in the region of the proximal tibial nerve with good filling of vessels proximal and distal to this, indicating that in generalised hypoperfusion states such as large vessel ligation, the area of poorest perfusion (and thus maximal damage) is not the distal vascular field, but a probable "watershed zone" between two adjacent nutrient vessels to the nerve.
本研究评估急性大血管缺血性神经病中外周神经微血管的变化。采用大血管结扎的动物模型来制造缺血性神经病：通过临床检查和神经传导研究记录神经病的存在及程度。使用铸型材料、甲基丙烯酸甲酯和硅橡胶来检查神经微循环，即“神经滋养血管”，随后通过光学显微镜和扫描电子显微镜进行观察。总共使用了10只动物，所有动物在结扎后1周均表现出缺血性神经病的临床证据。神经传导研究证实了这种缺血性神经病。在10只动物中的5只制作了铸型标本。对这些铸型标本的检查显示，所有5只动物胫神经近端区域的微循环均有充盈不足的区域，而该区域近端和远端的血管充盈良好，这表明在诸如大血管结扎这样的全身性低灌注状态下，灌注最差（因而损伤最大）的区域并非远端血管区域，而是神经的两条相邻营养血管之间可能存在的“分水岭区”。
