Baldissera F, Cavallari P, Marini G, Tredici G
Istituto di Fisiologia Umana II, University of Milan, Italy.
J Appl Physiol (1985). 1993 Aug;75(2):639-47. doi: 10.1152/jappl.1993.75.2.639.
Inspiratory activity of the paralyzed diaphragm was restored by reinnervation with brain stem laryngeal motoneurons. In 10 anesthetized cats, the right recurrent laryngeal nerve (RLN) was cut and anastomosed to the distal stump of either one or both roots (C5-C6) of the ipsilateral phrenic nerve. Three to four months later, reinnervation was assessed under deep anesthesia by the reappearance in the paralyzed diaphragm of 1) direct electromyographic (EMG) responses after electrical stimulation of the RLN and 2) spontaneous inspiratory bursts. Serial radiography, performed on five animals, revealed diaphragmatic excursions of comparable amplitude on the normal and reinnervated sides. Six to twelve months after anastomosis, laparotomy (performed under Nembutal anesthesia) allowed inspection and EMG recording of the spontaneous inspiratory contractions of the reinnervated areas and their sustained responses to tetanic RLN stimulation. Inspiratory discharges showed a ramplike recruitment similar to that of the normal diaphragm. Although the RLN contains a number of expiratory axons, multiple-site recordings disclosed expiratory EMG discharges only once. Histological analysis confirmed the substitution of phrenic axons by regenerating RLN fibers.
通过脑干喉运动神经元重新支配，恢复了麻痹膈肌的吸气活动。在10只麻醉猫中，切断右侧喉返神经（RLN），并将其与同侧膈神经一根或两根（C5 - C6）的远端残端吻合。三到四个月后，在深度麻醉下通过以下方式评估重新支配情况：1）电刺激RLN后，麻痹膈肌出现直接肌电图（EMG）反应；2）出现自发吸气爆发。对5只动物进行的系列放射照相显示，正常侧和重新支配侧的膈肌运动幅度相当。吻合术后六到十二个月，剖腹手术（在戊巴比妥麻醉下进行）可检查并记录重新支配区域的自发吸气收缩及其对RLN强直刺激的持续反应。吸气放电显示出类似于正常膈肌的斜坡样募集。尽管RLN包含许多呼气轴突，但多点记录仅一次显示出呼气EMG放电。组织学分析证实，膈神经轴突被再生的RLN纤维替代。
