内脏神经-体神经端侧吻合后神经再生方式的研究

目的 通过内脏神经-体神经端侧吻合建立人工体神经-内脏神经反射弧大鼠模型25只,荧光双标追踪技术研究神经再生方式.方法 在成活的21只模型鼠左侧盆神经节(MPG)内注射0.5μl荧光金(FG),腰4前根(L_4VR)的外周神经-坐骨神经注射1μl快蓝(FB)进行逆行神经追踪.应用组织化学方法 对吻合口远端的神经根(L6VR)进行甲苯胺蓝染色.结果 逆行追踪结果显示FG单标和FG-FB双标神经元主要分布于脊髓L_4左侧前角,FB单标神经元主要分布于脊髓L_3-L_6左侧前角.脊髓腰4节段每张切片上FG单标神经元、FB单标神经元、FG-FB双标神经元数目分别为(20.8±3.3)、(5.7±1.3)、(10.3±0.7).吻合口远端(L_6VR)再生的神经经甲苯胺蓝染色后可见轴突呈深蓝色.结论 逆行追踪结果证明内脏神经.体神经端侧吻合建立人工体神经.内脏神经反射弧后,体神经可以通过侧枝发芽的方式长入并替代内脏神经.

A retrograde tracer study of the regenerative nerve after end-to-side nerve anastomosis of distal stump of autonomic nerve to somatic nerve in rats

Objective To evaluate the collateral sprouting after end-to-side nerve anastomosis of distal stump of autonomic nerve to somatic nerve using a fluorescent double-labeling technique in rats.Methods In group I(end-to-side anastomosis),25 Sprague-Dawlcy(SD)rats had the left lumbar 6 ventral root transected in dura and the distal stump was sutured to the lateral face of left lumbar 4 ventral root without removing the epineurium.After 16 weeks,0.5μl Fluorogold(FC)and 1μl Fast Blue(FB)were respectively injected into the left major pelvic ganglia(MPG)and peripheral sciatic nerve(SN)for fluorescent retrogrnde tracing in 21 survival rats.The regenerative nerve was stained with teluidine blue through the use of histochemical technique.In groop Ⅱ(control),five SD rats have not been done any surgery and were treated the same fluorescent double-labeling as model rats of group Ⅰ.Results In group Ⅰ,after FG was iniected into the left MPG and FB was injected into SN,FC single labeled neurons and FG-FB dual labeled neurong were observed in locus of the left ventral hom of lumbar 3 caudal to lumbar 5 rostral,mainly in the left ventral horn of lumbar 4,FB single labeled neurons in locus of the left ventral ham of lumbar 3 caudal to lumbar 6.The number of FG single labeled neurons,FB single labeled neurons and FG-FB dual labeled neurons were(20.8±3.3),(5.7±1.3),(10.3±0.7)in every section of lumber fourth ventral horn,respectively.The recipient nerve axons were dyed blue after toluidine blue labeling.In control group,FG single labeled neurons were observed in locus of sacral parasympathetic nucleus of lumbar 6 to sacral 1 segment,FB single labeled neurons in locus of the left ventral horn of lumbar 3 caudal to lumbar 6,and FG-FB dual labeled neurons were not found.Conclusion The somatic motor axon ingrowth into autonomic nerve could be through collateral sprouting after end-to-side nerve anastomosis of distal stump of autonomic nerve to somatic nerve.It was concluded that the end-to-side neurorrhaphy could reconstitute the distal segment of a sectioned nerve.