腓肠神经的交感成分及其对腓肠神经营养血管皮瓣血流动力学影响的探查

发布时间：2018-05-25 02:05

本文选题：交感神经 + 腓肠神经　；参考：《中国临床解剖学杂志》2017年01期

【摘要】：目的探讨腓肠神经是否有发出交感纤维支配其伴行血管及腓肠神经切段后近端蒂腓肠神经营养血管皮瓣的血流动力学会出现何种相应变化。方法在探明兔下肢腓肠神经及其伴行血管相应解剖后,取17只白兔,其中2只白兔直接处死,取腓肠神经血管束。其余15只(30侧后肢)随机等分入神经保留组与神经切断组。神经保留组白兔在行皮瓣切取术后,不对腓肠神经进行处理;神经切断组则在皮瓣掀起后将腓肠神经在其起点处切断。在相应时间点处死两组动物,取腓肠神经营养血管束行乙醛酸染色。利用红外热像仪对上述两组皮瓣术后24 h皮瓣的平均温度进行测量。结果神经切断组术后3、5及7 d 3个时间点腓肠神经内荧光点及其伴行动脉外膜荧光出现高度一致性的下降,组间荧光评分具有显著性差异(F=13.563,P=0.004)。神经保留组在术后整个过程中荧光强度未出现明显改变。术后2 h起,神经保留组皮瓣平均温度低于神经切断组,两者差异具有统计学意义(P0.05)。结论腓肠神经有发出交感纤维至其伴行血管,调节其伴行血管张力。腓肠神经切段后,近端蒂腓肠神经营养血管皮瓣的微循环会出现相应改善,皮瓣存活率有可能增加。
[Abstract]:Objective to investigate the hemodynamic changes of sural nerve nutrient vascular flap with proximal pedicle pedicled with sural nerve after the sural nerve was innervated by sympathetic fibers. Methods after dissecting the sural nerve and its associated vessels of the lower extremities of the rabbits, 17 white rabbits were taken out, 2 of them were killed directly and the vascular bundles of sural nerve were taken out. The other 15 hind limbs were randomly divided into nerve preservation group and nerve transection group. In the nerve preserving group, the sural nerve was not treated after flap resection, while the sural nerve was cut off at its starting point in the nerve transection group after the flap was lifted. At the same time, the two groups were killed and the sural neurovascular bundles were stained with glyoxylic acid. The mean temperature of the two groups of flaps 24 hours after operation was measured by infrared thermograph. Results in the nerve transection group, the fluorescence of the sural nerve and its accompanying arterial adventitia decreased significantly at 3: 5 and 7 days after operation, and the fluorescence score was significantly different between the two groups (P < 0. 004, P < 0. 004). There was no significant change in fluorescence intensity during the whole process of operation in the nerve preservation group. From 2 hours after operation, the average temperature of the flap in the nerve preserving group was lower than that in the nerve transection group, and the difference was statistically significant (P 0.05). Conclusion the sural nerve has sympathetic fibers to its collateral vessels and regulates the tension of its accompanying vessels. The microcirculation of sural neurovascular flap pedicled with proximal pedicle of sural nerve was improved and the survival rate of the flap may be increased.
【作者单位】：福建医科大学附属第一临床医学院;福建医科大学神经生物研究所人体解剖与组织胚胎学系;
【基金】：省属高校高校专项基金(JK2014019) 国家自然科学资金(31401023) 福建省高校新世纪优秀人才基金(2016B029)
【分类号】：R622

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