不同神经毁损药局部注射对大鼠坐骨神经形态及功能的影响

目的 观察不同神经毁损药坐骨神经周围注射对坐骨神经形态及神经传导速度的影响.方法 SD大鼠105只,随机分为7组（n=15）：正常对照组（C组）、阿霉素组（Ad组）、无水乙醇组（Aa组）、8％酚甘油组（Pg1组）、10％酚甘油组（Pg2组）、12％酚甘油组（Pg3组）、庆大霉素组（Ci组）.在左侧坐骨神经分叉处分别注射各药0.2 ml,各组依次为0.9％生理盐水、5％阿霉素、无水乙醇、8％酚甘油、10％酚甘油、12％酚甘油、400 U/ml庆大霉素.分别于术后7、14、21 d时每组随机抽取5只,观察组织学改变、超微结构改变,并于21d时测定运动神经传导速度和复合肌肉动作电位波幅.结果 1、组织形态学：7 d时,除C组外,各组均出现不同炎性改变,并且Ad组、Ci组、Aa组、Pg1组、Pg2组、Pg3组逐渐加重.其他时点除C组、Ad组和Ci组外,各组均较前加重;2、超微结构：各时点除C组外,各组均出现各种病理变化,变化程度和趋势同组织形态学,Ad组轻于其余组;3、各组感觉神经传导速度和波幅均接近为0.与C组比较,各组运动神经传导速度和复合肌肉动作电位波幅均降低（P＜0.05）;与Ad组比较,Aa组、Pg1、Pg2、Pg3及Ci组的运动神经传导速度和波幅均降低（P＜0.05）.结论 与无水乙醇、酚甘油和庆大霉素相比,5％阿霉素在毁损感觉神经的同时,对运动神经功能的影响及造成的炎性反应较轻,提示其更适合作为神经毁损药物.

Effects of different neurolytic drugs on morphological changes and nervous function in rat sciatic nerve

Objective To investigate the morphological changes and nerve conduction velocity of sciatic nerve after injecting different neurolytic drugs into perineural of rat sciatic nerve. Methods Sprague-Dawley rats were randomly divided into 7 groups（n = 15）： group C received normal saline; group Ad 5% adriamycin; group Aa absolute ethyl alcohol; group Pgl 8% phenol-glycerol; group Pg2 10% phenol-glycerol; group Pg3 12% phenol-glycerol; group Ci 400 U/ml gentamicin. 0.2 ml of solution was injected at the point where the left sciatic nerve entering semi-membranous and adductor magnus muscles. Samples were taken for histological examination at 7, 14 and 21 d after the experiment. The action potential and conduction velocity of motor and sensory nerve fibers were measured at 21 d after the injection. Results 1. The inflammation was evident in all groups except group C at 7 d. The inflammation was aggravated gradually from group Ad, Ci, Aa, Pgl, Pg2 to Pg3; 2. There were inosculation of mitochondria membrane and cristae in all groups except group C. The trend and level were consistent with histology; 3. The conduction velocity of sensory nerve fibers was 0 in each group. The conduction velocity and action potential of the motor nerve fibers were significantly decreased in group Ad, Aa, Pg1, Pg2, Pg3 and Ci compared with group C. The action potential and the conduction velocity were significantly higher in group Ad than those in other neurolytic drug groups. The conduction velocity was lower in group Pg3 than that in group Aa. The conduction velocity in group Pgl, Pg2, Ci was comparable. Conclusion 5% adriamycin seems to be a better neurolytic drug with less interference with function of motor nerve fibers and milder inflammation than anhydrous alcohol, phenol-glycerol and gentamicin.