Wang Meng, Xu Wendong, Zheng Mouxiong, Teng Fei, Xu Jianguang, Gu Yudong
Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
Ann Plast Surg. 2011 Apr;66(4):370-6. doi: 10.1097/SAP.0b013e3181f322fd.
The aim of this study was to extend the clinical application of phrenic nerve neurotization in treating brachial plexus avulsion injury, reducing the possible damage on the diaphragm function. Fifty-one male Sprague-Dawley rats and 9 transgenic rats were used in this study. Evaluations including behavioral observation, histology, and electrophysiology study were performed postoperatively. The functional recovery of rats with the end-to-side neurorrhaphy reached 80% of those with end-to-end neurorrhaphy, and the function of diaphragm was preserved. The fluorescence study revealed abundant collateral sprouting of the phrenic nerve axons through the coaptation site in all the experimental groups. The study showed that the end-to-side neurorrhaphy in a helicoid manner and the standard end-to-side neurorrhaphy were effective in the treatment of brachial plexus root avulsion injury with little harm to the function of diaphragm. This will extend the clinical application of phrenic nerve neurotization in treating brachial plexus avulsion injury.
本研究的目的是扩展膈神经神经移植术在治疗臂丛神经撕脱伤中的临床应用，减少对膈肌功能可能造成的损害。本研究使用了51只雄性Sprague-Dawley大鼠和9只转基因大鼠。术后进行了包括行为观察、组织学和电生理学研究在内的评估。采用端侧神经缝合术的大鼠功能恢复达到端端神经缝合术大鼠的80%，且膈肌功能得以保留。荧光研究显示，在所有实验组中，膈神经轴突通过吻合部位有大量的侧支芽生。研究表明，螺旋状端侧神经缝合术和标准端侧神经缝合术在治疗臂丛神经根撕脱伤方面有效，且对膈肌功能损害较小。这将扩展膈神经神经移植术在治疗臂丛神经撕脱伤中的临床应用。
