运动皮层部分切除术对猕猴痉挛型偏瘫脑瘫模型的建立

发布时间：2018-05-13 00:44

本文选题：猕猴 + 动物模型　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的应用猕猴运动皮层部分切除术,建立婴幼猕猴痉挛型偏瘫脑瘫模型和评价方法。方法4只3月龄猕猴随机分为正常对照组和手术模型组。手术模型组猕猴:运用运动皮层部分切除术,切除右侧大脑外侧裂以上至半球间裂的中央前回皮质及额上回后部(正前中沟以前约0.3-0.5cm)皮质,深度约0.5-0.6cm。术后进行连续摄像,观察有无左侧肢体运动功能障碍和动静态的姿势异常;徒手检查和参考应用改良人Ashworth量表评定肌张力,应用自编粗大运动及精细运动评估量表检测两组运动障碍的量化指标,运用9.4T MRI检测颅脑的影像学改变。结果(1)手术模型组于术后立刻出现左侧肢体瘫痪,左上肢不能正常抬举,左下肢瘫痪,左侧肢体跛行明显,进食时主要以右侧肢体为主;手术组术后一周时活动量明显低于正常组,评分也低于正常组;2到3周后活动量增加,评分也开始升高,直至8周后,评分基本稳定。手术模型组和正常对照组的粗大运动评分在术后各个时期不完全相同(Friedman检验,χ2值为33.939,P0.05),精细运动评分在术后各个时期亦不完全相同(Friedman检验,χ2值为37.526,P0.05);(2)手术模型组术后姿势为静止时向左侧倾斜,蹲坐于猴笼一角,左上肢搭于猴笼网上以维持姿势平衡,运动时仍有向左侧倾斜,模拟出了人典型的痉挛型偏瘫脑瘫的临床表现;(3)徒手检查肌张力的改变:手术模型组术后即出现左侧肢体瘫痪和肌张力降低,5周后左侧肌张力逐渐开始增高,并逐渐加重至3级,持续到现在,肌张力在术后5周至术后14周术后各个时期不完全相同(Friedman检验,χ2值为20.713,P0.05);(4)术后3周头颅MRI显示右侧运动皮层切除术后疤痕组织形成,支持偏瘫脑瘫模型的影像学改变。结论(1)应用一侧运动皮层部分切除方法可成功建立婴幼猕猴痉挛型偏瘫脑瘫模型;(2)通过摄像观察猕猴的运动功能障碍和姿势异常表现,以及徒手检查肌力肌张力情况,结合自编适用于猕猴神经行为学评分和头颅影像学改变可准确评价猕猴脑性瘫痪偏瘫模型的建立;(3)真切地模拟出人类婴幼儿脑外伤性痉挛型偏瘫脑瘫模型,为脑瘫的病理机制和临床康复治疗的研究提供一个科学的平台。
[Abstract]:Objective to establish the model of cerebral palsy with spastic hemiplegia in infant rhesus monkey by partial resection of motor cortex. Methods four 3-month-old macaques were randomly divided into normal control group and surgical model group. In the model group, the cortex of precentral gyrus and posterior part of superior frontal gyrus (0.3-0.5 cm before anterior middle sulcus) was removed from right lateral fissure to interhemispheric fissure by partial resection of motor cortex, and the depth was about 0.5-0.6 cm. Postoperative continuous imaging was performed to observe whether there were left limb motor dysfunction and dynamic and static postural abnormalities, and muscle tension was evaluated with the improved human Ashworth scale. The quantitative indexes of motor disorders in the two groups were measured by using the self-made gross motion assessment scale and fine motion assessment scale, and the imaging changes of brain were detected by 9.4 T MRI. Results 1) in the operation model group, the left limb paralysis appeared immediately after operation, the left upper limb could not be lifted normally, the left lower extremity was paralyzed, the left limb claudication was obvious, and the main food intake was the right limb. The activity volume of the operation group was significantly lower than that of the normal group one week after operation, and the score was also lower than that of the normal group after 2 to 3 weeks, and the activity quantity increased, and the score began to increase, until 8 weeks later, the score was basically stable. The gross motor scores of the operation model group and the normal control group were not exactly the same as those of the postoperative model group and the normal control group. The 蠂 2 value of the model group was 33.939% (P 0.05), and the fine motor score was not exactly the same as the Friedman test and the 蠂 2 value was 37.526% P 0.05% (P 0.05) after operation in the model group. Tilt to the left when standing still, Crouching in the corner of the monkey cage, with the left upper limb resting on the cage net to maintain balance in posture, still tilting to the left when moving. The clinical manifestation of typical hemiplegic cerebral palsy in human was simulated. The changes of muscle tension were examined with bare hand: the left limb paralysis and the reduction of muscle tension appeared in the operation model group after 5 weeks, and the tension of the left side began to increase gradually after 5 weeks. The muscle tension was not exactly the same at every postoperative period from 5 weeks to 14 weeks after operation. The 蠂 2 value was 20.713 (P 0.05) 3 weeks after operation. The MRI showed the scar tissue formation after right motor cortex resection 3 weeks after operation. To support the imaging changes of hemiplegic cerebral palsy model. Conclusion 1) the model of spastic hemiplegic cerebral palsy in infantile rhesus monkeys can be successfully established by partial resection of unilateral motor cortex. The model of cerebral palsy hemiplegia in rhesus monkey can be accurately evaluated by using self-made neurobehavioral score and cranial imaging changes. The model of traumatic cerebral spastic hemiplegia in human infants can be truly simulated. To provide a scientific platform for the study of pathological mechanism and clinical rehabilitation of cerebral palsy.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.3;R-332

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