经皮电刺激对大鼠周围神经端侧吻合效果的影响

发布时间：2018-06-04 14:01

本文选题：电刺激 + 端侧缝合　；参考：《中国比较医学杂志》2017年12期

【摘要】：目的观察和探索经皮电刺激促进神经端侧吻合后神经再生的效果及其临床价值。方法选取雄性SD大鼠32只,随机分为正常对照组(A组),肌皮神经损伤后端端吻合至尺神经组(B组),肌皮神经损伤后端侧吻合至尺神经组(C组),肌皮神经损伤后端侧吻合至尺神经+术后经皮电刺激组(D组)。观察各组大鼠患侧肢体的肌力恢复情况以及神经纤维的再生情况。结果 C组和D组大鼠振幅、传导速度低于A组,潜伏期高于A组;而D组大鼠振幅、传导速度低于C组,潜伏期高于C组;B、C、D三组大鼠肱二头肌湿重比以及肌纤维横截面积均低于A组,且C组肌肉恢复最差;B、C、D三组大鼠NF-200表达明显低于A组,D组NF-200表达明显强于C组,但仍显著少于B组,差异均具有显著性(P0.05)。电镜检查显示B组神经纤维髓鞘成熟,C组以无髓神经纤维为主,髓鞘成熟度差。D组髓鞘增生情况较C组好转,但仍有部分无髓神经纤维存在。结论神经端侧吻合术后经皮电刺激能有效促进神经轴突再生以及延缓靶肌的失神经萎缩,尽管较之神经端端吻合存在差距,仍不失为临床修复周围神经损伤的有效方法之一。
[Abstract]:Objective To observe and explore the effect and clinical value of nerve regeneration after percutaneous electrical stimulation to promote nerve end to side anastomosis. Methods 32 male SD rats were selected and randomly divided into normal control group (group A). The end to end anastomosis to the ulnar nerve group (group B), the end to end anastomosis to the ulnar nerve group (group C), and the injury of the musculocutaneous nerve in the muscle skin nerve injury were divided into the normal control group (group B). The posterior end side anastomosed to the ulnar nerve plus percutaneous electrical stimulation group (group D). The muscle strength recovery and the regeneration of the nerve fibers were observed in each group of rats. Results the amplitude and conduction velocity of C and D rats were lower than that of group A and the latency was higher than that of the A group; and the amplitude, conduction velocity of the rats in group D was lower than that of the C group, and the incubation period was higher than that of the C group; B, C, D three rats The wet weight ratio of biceps brachii and the cross sectional area of muscle fiber were lower than that in group A, and the muscle recovery of group C was the worst. The expression of NF-200 in B, C, D three groups was significantly lower than that in group A, and the NF-200 expression in D group was significantly stronger than that in C group, but the difference was significantly less than that in B group (P0.05). The myelinosis in group.D was better than that in group C, but there was still some non myelinated nerve fibers in the group. Conclusion the skin electrical stimulation after end to side anastomosis of the nerve can effectively promote the regeneration of the axon and postpone the atrophy of the denervation of the target muscle, although there is a gap between the end of the nerve and the nerve end anastomosis, it is still a clinical repair of peripheral nerve injury. One of the effective methods.
【作者单位】：常熟市第二人民医院手足外科;
【基金】：常熟市科技计划项目任务书(csws201302)
【分类号】：R651.3

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