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[周围神经综述]

[Review of the peripheral nerve].

作者信息

Rigoard P, Lapierre F

机构信息

Service de neurochirurgie, CHU La Milétrie, 2, rue de la Milétrie, BP 577, 86021 Poitiers cedex, France.

出版信息

Neurochirurgie. 2009 Oct;55(4-5):360-74. doi: 10.1016/j.neuchi.2009.08.156. Epub 2009 Sep 26.

Abstract

The peripheral nerve provides the pathway for motor, sensory, and vegetative axons belonging to the peripheral nervous system. It transmits information between these neurons and their peripheral effectors in both directions (sensory receptors, skeletal muscles, and viscera). The afferences to the periphery correspond to the nerve motor content, whereas efferences from the periphery, in charge of delivering information to the central integrators, correspond to nerve-sensitive content. This information support depends on the intrinsic properties of the nerve itself. Peripheral nerve injuries are frequent and generate significant deficits. Their treatment sometimes leads to functional recovery but is mostly incomplete or unpredictable, despite the regular use of sophisticated repair techniques. The clinician must clearly understand the peripheral nervous system's responses to injury, which reveal surprising degenerating and spontaneous regenerating abilities. This potential recovery is a peripheral nervous system specificity and follows a relatively complex process. Peripheral neurons depend on glial cell structure and metabolism, inducing the global and dynamic response of the whole axon environment, even in cases of focal lesion, modulated by the initial type and mechanism of injury. Today's progress remains insufficient to improve functional prognosis significantly, but a better understanding of peripheral nerve regenerating processes obtained in cellular and molecular biology has opened the door to new medical and surgical advances.

摘要

周围神经为属于周围神经系统的运动、感觉和自主神经轴突提供了通路。它在这些神经元与其周围效应器之间双向传递信息(感觉感受器、骨骼肌和内脏)。向周围的传入神经对应于神经运动成分,而从周围发出的、负责将信息传递给中枢整合器的传出神经则对应于神经感觉成分。这种信息支持取决于神经本身的内在特性。周围神经损伤很常见,并会导致严重的功能缺陷。尽管经常使用复杂的修复技术,但其治疗有时会导致功能恢复,但大多是不完全的或不可预测的。临床医生必须清楚地了解周围神经系统对损伤的反应,这些反应显示出惊人的退化和自发再生能力。这种潜在的恢复是周围神经系统的特性,并且遵循一个相对复杂的过程。周围神经元依赖于神经胶质细胞的结构和代谢,即使在局灶性病变的情况下,也会引发整个轴突环境的整体动态反应,这受到损伤的初始类型和机制的调节。如今的进展仍然不足以显著改善功能预后,但在细胞和分子生物学方面对周围神经再生过程有了更好的理解,为新的医学和外科进展打开了大门。

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