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大鼠端侧神经缝合双肌肉神经支配

Double muscle innervation using end-to-side neurorrhaphy in rats.

作者信息

Stipp-Brambilla Elisangela Jeronymo, Viterbo Fausto, Labbé Daniel, Garbino José Antonio, Bernardelli Maíra Miranda

机构信息

Department of Surgery and Orthopedics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2012;130(6):373-9. doi: 10.1590/s1516-31802012000600004.

Abstract

CONTEXT AND OBJECTIVE

One of the techniques used for treating facial paralysis is double muscle innervation using end-to-end neurorrhaphy with sectioning of healthy nerves. The aim of this study was to evaluate whether double muscle innervation by means of end-to-side neurorrhaphy could occur, with maintenance of muscle innervation.

DESIGN AND SETTING

Experimental study developed at the Experimental Research Center, Faculdade de Medicina de Botucatu, Unesp.

METHODS

One hundred rats were allocated to five groups as follows: G1, control group; G2, the peroneal nerve was sectioned; G3, the tibial nerve was transected and the proximal stump was end-to-side sutured to the intact peroneal nerve; G4, 120 days after the G3 surgery, the peroneal nerve was sectioned proximally to the neurorrhaphy; G5, 120 days after the G3 surgery, the peroneal and tibial nerves were sectioned proximally to the neurorrhaphy.

RESULTS

One hundred and fifty days after the surgery, G3 did not show any change in tibial muscle weight or muscle fiber diameter, but the axonal fiber diameter in the peroneal nerve distal to the neurorrhaphy had decreased. Although G4 showed atrophy of the cranial tibial muscle 30 days after sectioning the peroneal nerve, the electrophysiological test results and axonal diameter measurement confirmed that muscle reinnervation had occurred.

CONCLUSION

These findings suggest that double muscle innervation did not occur through end-to-side neurorrhaphy; the tibial nerve was not able to maintain muscle innervation after the peroneal nerve had been sectioned, although muscle reinnervation was found to have occurred, 30 days after the peroneal nerve had been sectioned.

摘要

背景与目的

治疗面瘫的技术之一是通过端端神经缝合切断健康神经进行双肌肉神经支配。本研究的目的是评估通过端侧神经缝合进行双肌肉神经支配是否会发生,并维持肌肉神经支配。

设计与地点

在圣保罗州立大学博图卡图医学院实验研究中心开展的实验研究。

方法

将100只大鼠分为五组,如下:G1,对照组;G2,切断腓总神经;G3,切断胫神经,将近端残端端侧缝合至完整的腓总神经;G4,在G3手术120天后,在神经缝合近端切断腓总神经;G5,在G3手术120天后,在神经缝合近端切断腓总神经和胫神经。

结果

手术后150天,G3组胫肌重量和肌纤维直径无变化,但神经缝合远端腓总神经的轴突纤维直径减小。尽管G4组在切断腓总神经30天后出现颅侧胫肌萎缩,但电生理测试结果和轴突直径测量证实发生了肌肉再支配。

结论

这些发现表明,通过端侧神经缝合未发生双肌肉神经支配;在切断腓总神经后,胫神经无法维持肌肉神经支配,尽管在切断腓总神经30天后发现发生了肌肉再支配。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e39e/10522314/393580b0fbe6/1806-9460-spmj-130-06-373-gf1.jpg

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