吻合血管或吻合血管及神经的游离小肌肉移植实验及临床意义

目的 探讨吻合血管或吻合血管及神经的游离小肌肉移植动物实验的效果比较及临床应用.方法 将新西兰雄兔32只随机分为两组,A组16只做Ⅰ期吻合血管的游离肱二头肌移植;B组16只做Ⅰ期吻合血管及神经的游离肱二头肌移植.分别于手术后2个月、3个月进行肱二头肌肌电图检测.结果 A组的肱二头肌肌电图峰值:2个月为(2.02±0.41)mV;3个月为(1.73±0.18)mV.B组的肱二头肌肌电图峰值;2个月为(3.90±0.52)mV;3个月为(3.35±0.86)mV.经统计学处理,t检验结果 两组差异有统计学意义(P<0.01).而两组实验肌电图的潜伏期差异无统计学意义(P>0.05).结论 吻合血管及神经的小肌肉移植肌力恢复效果确切,且创伤较小,不会发生继发畸形和功能障碍,实验结果 显示值得临床推广应用于面瘫的治疗.

Clinical implication of anastomosed vascular or nenrovascular mini-muscle transfer: an experimental study

Objective To investigate the functional changes of anastomosed vascular or neurovascular mini-muscle transfer and to provide experimental data to clinical application. Methods 32 New Zealand rabbits were operated on by anastomosed neurovascular mini-muscle transfer. In group A, 16 rabbits accepted the anastomosed vascular mini-muscle transfer. In group B, 16 rabbits accepted the anastomosed neurovascular mini-muscle transfer. The electromyography was measured 2 months and 3 months after operation. Results The amplitude of electrical muscle graph (EMG) data in the group A was (2.02±0.41)mV 2 months after operation, and (1.73±0.18) mV 3 months after operation. The EMG data in the group B was (3.90±0.52) mV 2 months after operation and (3.35±0.86) mV 3months after opera-tion. The difference between the two groups was significant (P<0.01). The EMG of anastomosed neu-rovasular mini-muscle transfer was significantly greater than that of anastomosed vasular transfer only.There was no significant difference in latent period of EMG between the two groups (P>0.05). Conclu-sions The muscle functional recovery of anastomosed neurovascular mini-muscle transfer is significant with less demage and no secondary deformity. The results suggest that this technique is worthy to apply for treating facial paralysis.