应用端侧吻合修复高位尺神经损伤的研究

目的 探讨高位尺神经损伤后尽早恢复手内在肌功能的一种修复方法。方法 纯种大耳白兔18只，采用同体自身对照方法。左侧高位尺神经切断后直接吻合，同时在低位（前肢远端）切断尺神经，将其远侧断端与正中神经外膜开窗处作端侧吻合为实验侧，右侧尺神经高位切断后直接吻合为对照侧。按手术先后分为A、B、C三个时间组，分别于术后4、8、12周时做电生理检测和组织学检查。结果 A、B、C三组实验侧均测出诱发电位，而对照侧均未测出诱发电位。组织学观察结果显示术后4、8、12周时实验侧神经纤维数量、密度随时间延长而逐渐增加．而对照侧未检测到再生神经纤维。结论 高位尺神经损伤后在高位端端吻合恢复手外在肌功能的同时加低位端侧吻合可作为尽早恢复手内在肌的功能的一种新方法。

The ulnar nerve injury repair by end-to-side neurorrhaphy

Objective To study the possibility of repair of the ulnar nerve injuried in arm by endto-side neurorrhaphy. Methods Eighteen rabbits were studied. On the left side the ulnar nerve was repaired in an end-to-end fashion in arm. At the same time the ulnar nerve was transected in forearm, and the distal end of the nerve was sutured to the windowed median nerve by end-to-side fashion. On the right side the ulnar nerve was repaired in an end-to-end fashion just in arm as control. Regeneration was tested via electromyographic examination and histological examination at postoperative 4 weeks in group A, postoperative 8 weeks in group B and postoperative 12 weeks in group C, with 6 rabbits each. Results Just on the left side nerve regeneration in the hypothenar muscles inervated by the ulnar nerve could be detected at postoperative 4, 8 and 12 weeks. Histological examination showed that the number and density of regenerated nerve fibers were increased at postoperative week 4, 8 and 12 respectively. On the right side there was degeneration. Conclusion End-to-side neurorrhaphy is a new valuable method for repair of ulnar nerve iniuried in arm.