家兔创伤性面神经损伤的组织病理学研究

为了建立各种面神经损伤的实验动物模型，对６８只家兔１３６侧面神经颊面干分别造成暴露、牵拉、挤压、压榨及切断后吻合与不吻合６种损伤，于伤后不同时间取材，切片行Ｂｏｄｉａｎ及Ｗｅｉｌ染色，光镜下观察神经轴突、髓鞘、Ｓｃｈｗａｎｎ细胞及神经纤维周围结缔组织的变化。结果表明，暴露可造成神经Ⅰ度损伤；挤压、牵拉、压榨可造成Ⅱ～Ⅲ度损伤；神经断裂后不吻合者预后明显较吻合者差。神经受损后的病理改变，在中、重度损伤与神经电图变化相一致，而轻度损伤及严重损伤后期两者可能不一致。伤后１５天为临床评价面神经功能恢复的最佳时间。神经受损面积对髓鞘病变影响明显，而损伤性质及程度对轴突病变影响明显。该动物模型的建立为深入进行面神经损伤及修复的研究提供了条件。

Histopathological study on traumatic facial nerve injury in the rabbits

Six patterns of injuries (exposure, compression, crush, stretch, division and post-division anastomosis) were analysed in 136 facial nerve buccal branches of 68 rabbits in order to establish the experimental model for study of traumatic facial nerve injury. Changes of histopathology at definite time were studied. The results showed that: exposure can create degree I injury; compression, stretch and crush can create degree II-III injury; the prognosis in anastomosis group was obviously better than unanastomosis group. In moderate to serious injuries, changes of histopathology and ENoG were synchronized, but were not so in mild and later stage of serious injury. The 15th day postinjury was the best time of estimating the facial nerve function clinically. The area of injury would obviously influence the mylin lesion, while the quality and degree of injury would obviously influence the axonal lesion.