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高压氧对外周神经的影响。

Effects of hyperbaric oxygen on peripheral nerves.

作者信息

Eguiluz-Ordoñez Raquel, Sánchez Cuauhtémoc E, Venegas Aureliano, Figueroa-Granados Víctor, Hernández-Pando Rogelio

机构信息

Hyperbaric Medicine Department, Hospital Angeles del Pedregal, Mexico City, Mexico.

出版信息

Plast Reconstr Surg. 2006 Aug;118(2):350-7; discussion 358-9. doi: 10.1097/01.prs.0000227666.64552.81.

Abstract

BACKGROUND

Injuries of peripheral nerves are common and usually are part of acute traumatic injuries to the limbs. Damage to peripheral nerves may be extensive. Microsurgery has improved the rate of recovery of these injuries, but some problems remain to be solved. The purpose of this investigation was to study the long-lasting effects of hyperbaric oxygenation on peripheral nerves after transection and repair with microsurgery in the rat sciatic nerve model.

METHODS

Forty male Wistar rats were divided randomly into four groups: (1) no hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 7 weeks; (2) hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 7 weeks; (3) no hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 14 weeks; and (4) hyperbaric oxygen, sectioned and repaired (n = 10), euthanized at 14 weeks. Nerve recovery was assessed by neurophysiologic studies at 7 or 14 weeks. Foot-ankle angle response (dorsiflexion) and histopathology with automated morphometry were performed after 7 or 14 weeks. Statistical analysis was performed with the Friedman test and the Mann-Whitney U test.

RESULTS

At 7 weeks, motor latency showed statistical significance in both groups, treated and not treated, whereas amplitude, axons, and blood vessel number was higher in the hyperbaric oxygen-treated group. After 14 weeks, electromyography showed no denervation and a better foot-ankle angle response in the hyperbaric oxygen groups.

CONCLUSION

These results suggest that functional recovery in transected peripheral nerves may be improved and accelerated by hyperbaric oxygenation following microsurgical repair.

摘要

背景

周围神经损伤很常见,通常是肢体急性创伤性损伤的一部分。周围神经损伤可能很广泛。显微外科手术提高了这些损伤的恢复率,但仍有一些问题有待解决。本研究的目的是在大鼠坐骨神经模型中,研究高压氧对周围神经横断并显微外科修复后长期的影响。

方法

40只雄性Wistar大鼠随机分为四组:(1)无高压氧,切断并修复(n = 10),7周时安乐死;(2)高压氧,切断并修复(n = 10),7周时安乐死;(3)无高压氧,切断并修复(n = 10),14周时安乐死;(4)高压氧,切断并修复(n = 10),14周时安乐死。在7周或14周时通过神经生理学研究评估神经恢复情况。在7周或14周后进行足-踝角度反应(背屈)和组织病理学及自动形态计量学分析。采用Friedman检验和Mann-Whitney U检验进行统计学分析。

结果

7周时,运动潜伏期在治疗组和未治疗组均有统计学意义,而高压氧治疗组的波幅、轴突和血管数量更高。14周后,肌电图显示高压氧组无失神经支配且足-踝角度反应更好。

结论

这些结果表明,显微外科修复后高压氧可改善并加速横断周围神经的功能恢复。

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