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端侧神经吻合术后感觉轴突的侧支发芽——大鼠的纵向研究

Collateral sprouting of sensory axons after end-to-side nerve coaptation--a longitudinal study in the rat.

作者信息

Kovacic Uros, Tomsic Martin, Sketelj Janez, Bajrović Fajko F

机构信息

Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia.

出版信息

Exp Neurol. 2007 Feb;203(2):358-69. doi: 10.1016/j.expneurol.2006.08.018. Epub 2006 Oct 10.

Abstract

The end-to-side nerve coaptation is able to induce collateral sprouting of axons from the donor nerve and to provide functional reinnervation of the target tissue. Sensory axon sprouting and its effects on the donor nerve up to 9 months after the end-to-side nerve coaptation were studied in the rat. Peroneal, tibial and saphenous nerves were transected and ligated, and the distal stump of the transected peroneal nerve was sutured to the side of the uninjured sural nerve. The average skin area of the residual sensitivity to pinch due to the axons sprouting through the recipient peroneal nerve did not change statistically significantly between 4 and 9 months after surgery. Axon counting, measurements of compound action potentials and retrograde neuron labeling indicate that the sprouting of the myelinated sensory axons and unmyelinated axons through the recipient nerve was largely completed by 2 months and 4 months after the end-to-side nerve coaptation, respectively, and remained stable thereafter for at least 9 months. A decrease in the amplitude and area of the CAP of myelinated fibers, observed in the donor nerve up to 4 months after surgery, was probably due to mild degeneration of nerve fibers and a tendency of the diameter of myelinated axons to decline. However, no significant changes in functional, electrophysiological or morphological properties of the donor nerve could be observed at the end of the observational period, indicating that end-to-side nerve coaptation has no detrimental effect on the donor nerve on a long-term scale.

摘要

端侧神经吻合能够诱导供体神经轴突的侧支发芽,并为靶组织提供功能性再支配。在大鼠中研究了端侧神经吻合后长达9个月的感觉轴突发芽及其对供体神经的影响。切断并结扎腓总神经、胫神经和隐神经,将切断的腓总神经远端残端缝合到未受伤的腓肠神经侧面。术后4至9个月,由于轴突通过受者腓总神经发芽而导致的残留捏压敏感性平均皮肤面积在统计学上没有显著变化。轴突计数、复合动作电位测量和逆行神经元标记表明,有髓感觉轴突和无髓轴突分别在端侧神经吻合后2个月和4个月时基本完成通过受者神经的发芽,此后至少9个月保持稳定。在术后长达4个月的供体神经中观察到的有髓纤维复合动作电位(CAP)幅度和面积的降低,可能是由于神经纤维的轻度退变以及有髓轴突直径有下降趋势。然而,在观察期结束时,未观察到供体神经的功能、电生理或形态学特性有显著变化,这表明端侧神经吻合在长期范围内对供体神经没有有害影响。

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