神经功能指数评价不同腓神经修复方式对神经功能恢复的影响

背景目前已有大量文献证实了神经功能指数评价鼠坐骨神经损伤后功能恢复程度的可靠性,且经常被用来评价大鼠坐骨神经及其分支损伤后功能恢复的程度.目的本文拟用神经功能指数评价不同腓神经修复方式对神经功能的影响.设计随机对照的研究.地点和材料实验在北京大学医学部动物实验室完成,所需的实验材料为20只SD鼠.方法将大鼠随机分为两组,两组中作为支持神经的胫神经均先行去外膜的"开窗"术,第1组行腓神经与胫神经"开窗"端侧缝合,第2组行腓神经与胫神经"开窗"的侧侧缝合.分别在术后的3,6,11,16周通过足印分析法计算出这两组的腓神经功能指数(peroneal nervefunctional index,PFI),用t检验比较两组功能指数的差异.主要观察指标术后不同时间点两实验组PFI的差异.结果术后6周第1组PFI为-39.92±11.67,第2组PFI为-64.49±31.31,差异有显著性意义(t=-2.315,P=0.033);术后16周第1组PFI为-27.43±12.54,第2组PFI为-15.66±9.81,差异有显著性意义(t=2.314,P=0.048).结论腓神经术后16周鼠类腓神经与胫神经侧侧缝合修复法功能恢复较端侧缝合法优.

Evaluating the effects of different peroneal neurorrhaphies on functional recovery by nerve function index

BACKGROUND: The reliability of nerve function index(NFI) for evaluating functional recovery following rat sciatic nerve injury has been confirmed by many researches; moreover, NFI has been commonly used to assess functional recovery after sciatic nerve injury and its branches injuries in rat model.OBJECTIVE: To assess the effect of different peroneal neurorrhaphy on nerve function recovery by NFI.DESIGN: A randomised case-control study.SETTINGS and MATERIALS: The experiment was conducted at the Experimental Animal laboratory of Peking University Health Siences Center. Totally twenty SD rats were used.METHODS: All rats were randomly divided into two groups after removing a small epineural window at tibial nerve (TN) that used as donor nerve. The distal end of PN was sutured to the lateral face of the TN in group A, while PN and TN were reinnervated by side -to-side neurorraphy in group B. Footprint analysis was used to calculate Peroneal nerve function index(NFI) of the two groups at 3, 6, 11, 16 weeks after operation,and the difference of PFI between two groups was compared with t test.MAIN OUTCOME MEASURES: The difference of PFI between two groups at different postoperative time points.RESULTS: PFI was - 39. 92 + 11.67 in group A at 6th week postoperatively, significantly different from -64.49 +31.31 of group B, (t = -2. 315,P = 0. 033) PFI was - 27.43 ± 12.54 in group A and - 15.66 ± 9.81 in group B at 16 weeks postoperatively, with significant difference( t = 2. 314,P=0. 048).CONCLUSION: Side-to-side reinnervation by PN and TN was superior to distallateral neurorraphy for nerve functional recovery at 16 weeks after PN operation in rat models.