构建生物人工神经修复周围神经缺损的实验研究

目的：探讨生物人工神经对周围神经再生的作用。方法：用自体雪旺氏细胞、Ⅳ型胶原及可降解的聚乳酸导管构建生物人工神经，桥接10mm缺损的鼠坐骨神经，对照组行自体神经移植，术后8周，2组行大体观察、组织学检查及神经电生理检查。结果：实验组再生神经纤维数、再生轴突恢复率、运动神经传导速度及复合肌肉动作电位振幅均同对照组相近。结论：实验构建的生物人工神经能有效的促进周围神经再生。     

桡神经非创伤性神经束扭转的临床研究

目的探讨桡神经非创伤性神经束扭转的发病机理和治疗结果。方法结合5例临床桡神经非创伤性神经束扭转患者病史、术中发现、病理结果及治疗经过,对该病的发病机制及治疗方法进行初步探讨。结果5例桡神经非创伤性神经束扭转患者在临床表现及术中所见均与典型周围神经嵌压患者不同,积极手术干预,临床效果满意。结论周围神经的螺旋样结构及其滋养血管的炎症表现是导致非创伤性神经束扭转的两个重要原因。     

人体膈神经与副膈神经的组织化学研究

研究人体膈神经与副膈神经的运动纤维数量及有髓纤维截面积。方法：运用Ｋａｍｏｖｓｋｙ－Ｒｏｏｔｓ［１］乙酰胆碱酯酶组织化学方法，研究１２例成人膈神经及并存的５例副膈神经。对轴索内酶活性反应呈阳性的纤维，进行计数及纤维截面积图象分析。结果：膈神经与副膈神经绝大部分有髓纤维酶反应呈阳性，所含阳性有膈纤维分别为２６８６根、６３４根。膈神经与副膈神经并存时有髓纤维总数达３２１８根。有髓纤维截面积分别为１０３．８μｍ２、９４．７μｍ２。结论：膈神经含２６８６根运动纤维，有髓纤维截面积为１０３．８μｍ２，是良好的移位动力神经；副膈神经与其并存，有重要的临床意义。     

咬肌神经-面神经吻合：跨面神经移植手术的有效补充

目的初步阐述咬肌神经-面神经吻合手术的方法和疗效。方法2例听神经瘤术后完全性面瘫患者,进行跨面神经移植术和患侧部分咬肌神经-面神经吻合手术。结果术后3个月,患者咬牙后可将口角上提和闭合眼睛,咀嚼功能没有影响,面部未出现凹陷畸形。结论咬肌神经-面神经吻合可以有效、快速地重建面部肌肉的神经支配,是跨面神经移植手术的有效补充。     

基膜管－自体神经嵌合体修复大鼠周围神经缺损的实验研究

目的 寻找一种简单有效,修复长段周围神经缺损的方法.方法 在两段同种异体大鼠的脱细胞坐骨神经之间置入一段自体坐骨神经,形成基膜管-自体神经嵌合体,与单纯基膜管、硅胶管带自体神经、单纯硅胶管、自体神经等其他桥接物比较修复神经缺损的效果.结果 分组动物实验显示基膜管-自体神经嵌合体组的神经功能、形态恢复最佳.结论 基膜管-自体神经嵌合体修复周围神经缺损简单有效,并能延长修复长度,在修复长段周围神经缺损方面有着良好的应用前景.     

Superficial Peroneal Nerve (Superficial Fibularis Nerve): The Clinical Implications of Anatomic Variability

The purpose of this study is to refine further the knowledge about the anatomic variability of the superficial peroneal nerve in the middle third of the leg. Approaching the superficial peroneal nerve in this location is required: 1) when either the deep or the superficial peroneal nerve must be resected for the treatment of dorsal foot pain; 2) when a neurolysis of the superficial peroneal nerve is required; 3) when a fasciotomy must be performed either for trauma or for exertional compartment syndrome surgery; and 4) during elevation of a fasciocutaneous or fibular flaps. Because of the variability encountered during these procedures, a prospective study was carried out via lower extremity cadaver dissection with fresh, frozen specimens. A total of 35 nonpaired lower extremities and 40 paired lower extremities were dissected with 3.5 loupe magnification. The superficial peroneal nerve was identified in the lateral compartment immediately adjacent to the fascial septum in 72% of the specimens (54 of 75), with a branch in both the anterior and the lateral compartment in 5% of the specimens (4 of 75), and located in the anterior compartment in only 23% of the specimens (17 of 75). The clinical implications of these anatomic findings are that the surgeon operating in the anterior and lateral compartments of the leg should be aware that the superficial peroneal nerve may be located in the lateral compartment and may also exhibit branches in both the anterior and lateral compartments.     

Malignant Peripheral Nerve Sheath Tumor Arising in Association With the Sural Nerve

Malignant peripheral nerve sheath tumor is a rare sarcoma of peripheral nerves found most often in deep soft tissue. This aggressive tumor is difficult to diagnose clinically and must be surgically excised for therapy. An incisional biopsy will allow for testing and in most cases, diagnosis. The authors present a case of a 39-year-old African American woman with malignant peripheral nerve sheath tumor in association with the sural nerve. The tumor was surgically removed and sent for pathologic studies. The patient reported to her first postoperative appointment and was referred to an oncologist for follow-up. Despite multiple attempts at contacting the patient and explaining the prognosis of the diagnosis, the patient refused further follow-up care including referral to an oncologist.