大鼠周围神经端侧吻合后再生纤维来源和状况的研究

目的：探索周围神经端侧吻合后再生纤维的来源及状况。方法：SD雄性大鼠20只，随机分为端侧吻合(E-S)组和端端吻合(E-E)组，E-S组右侧建立胫腓神经端侧吻合模型，E-E组右侧建立腓神经端端吻合模型，术后3个月，行透射电镜、电生理检查及辣根过氧化物酶(horseradish pemxidase，HRP)标记神经元。结果：潜伏期运动神经传导速度(MNCV)及混合神经传导速度(CNCV)E-E组均优于E-S组，E-S组脊髓前角内侧及脊神经节均可观察到HRP标记的阳性细咆，吻合口远端有髓神经纤维再生。结论：腓神经远端的再生纤维来源于胫神经，再生纤维中感觉纤维和运动纤维均有；尽管端端吻合再生纤维质量优于端侧吻合，但端侧吻合仍不失为神经修复的一种选择。

Experimental study of origin of the regenerating axons and effect after peripheral nerve end-to-side anastomosis in rats

Objective: To investigate the origin of the regenerating axons and effect after peripheral nerve end to side anastomosis. Methods: 20 male SD rats were randomly divided into two groups (E S group and E E group). In E S group, the distal end of right peroneal nerve was end to side anastomosed to tibial nerve. In E E group, right peroneal nerves were transected and sutured in end to end way. Electron microscopic, electrophysiological tests and HRP retrograde tracing were observed after 3 months. Results: The shorter latency, MNCV and CNCV were not as good as those of end to end anastomosis, and the HRP marking cells existed in medial part of anterior horn and spinal ganglion, and the myelinated nerve fibers were observed in the distal end of peroneal nerve. Conclusion: The regenerative fibers originated from collateral sprouting of tibial nerve. It provided another option for surgical treatment of nerve repair although the regenerative fibers of end to end anastomosis were superior to that of end to side anastomosis.