Zhang Xiu-Xiu, Kou Yu-Hui, Yin Xiao-Feng, Jiang Bao-Guo, Zhang Pei-Xun
Department of Orthopedics and Trauma, Peking University People's Hospital, Beijing, China.
Neural Regen Res. 2017 Jul;12(7):1172-1176. doi: 10.4103/1673-5374.211199.
Motor nerves and sensory nerves conduct signals in different directions and function in different ways. In the surgical treatment of peripheral nerve injuries, the best prognosis is obtained by keeping the motor and sensory nerves separated and repairing the nerves using the suture method. However, the clinical consequences of connections between sensory and motor nerves currently remain unknown. In this study, we analyzed the anatomical structure of the rat femoral nerve, and observed the motor and sensory branches of the femoral nerve in the quadriceps femoris. After ligation of the nerves, the proximal end of the sensory nerve was connected with the distal end of the motor nerve, followed by observation of the changes in the newly-formed regenerated nerve fibers. Acetylcholinesterase staining was used to distinguish between the myelinated and unmyelinated motor and sensory nerves. Denervated muscle and newly formed nerves were compared in terms of morphology, electrophysiology and histochemistry. At 8 weeks after connection, no motor nerve fibers were observed on either side of the nerve conduit and the number of nerve fibers increased at the proximal end. The proportion of newly-formed motor and sensory fibers was different on both sides of the conduit. The area occupied by autonomic nerves in the proximal regenerative nerve was limited, but no distinct myelin sheath was visible in the distal nerve. These results confirm that sensory and motor nerves cannot be effectively connected. Moreover, the change of target organ at the distal end affects the type of nerves at the proximal end.
运动神经和感觉神经传导信号的方向不同，功能方式也不同。在周围神经损伤的外科治疗中，通过保持运动神经和感觉神经分离并采用缝合方法修复神经可获得最佳预后。然而，目前感觉神经与运动神经连接的临床后果尚不清楚。在本研究中，我们分析了大鼠股神经的解剖结构，并观察了股神经在股四头肌中的运动和感觉分支。在神经结扎后，将感觉神经的近端与运动神经的远端相连，随后观察新形成的再生神经纤维的变化。采用乙酰胆碱酯酶染色来区分有髓鞘和无髓鞘的运动神经和感觉神经。对失神经支配的肌肉和新形成的神经进行形态学、电生理学和组织化学方面的比较。连接后8周，在神经导管两侧均未观察到运动神经纤维，近端神经纤维数量增加。导管两侧新形成的运动和感觉纤维比例不同。近端再生神经中自主神经所占面积有限，但远端神经中未见明显的髓鞘。这些结果证实感觉神经和运动神经不能有效连接。此外，远端靶器官的变化会影响近端神经的类型。
