周围神经修复过程中束膜再生的方式及其意义

家兔坐骨神经胫神经束横断吻合和单纯挤压损伤后光、电镜对照观察,发现束膜损伤后能够修复,其方式是形成一含有许多神经小束的新外膜-束膜管,从而实现两断端束膜的再连接。神经切断缝合后至新外膜-束膜管的形成,外膜、束膜的变化可分为三期,即创伤性炎性反应,束膜变性坏死期,前束膜细胞增殖、神经纤维长入期与再生神经小束形成期。新外膜-束膜管的形成对神经的再生具有重要意义,能阻止新生的神经纤维向外生长并诱导其长入远端束膜管。作者考虑,再生束膜细胞可能来自束膜细胞本身的增殖。本文还描述了兔坐骨神经束膜的正常组织学和超微结构态形,束膜细胞核有作栅状排列的倾向,似可解释神经纤维瘤细胞每作栅状排列的现象。

An Experimental Study on the Pattern and Significance of Perineurium Regeneration during Peripheral Nerve Repair

The repair process of the iibial fascicle of the rabbit sciatic nerve which had been transected and sutured or simply crushed was studied by means of light and . electron microscopy.It was found that the perineurium was able to heal after the nerve had been transected and sutured through the formation of a new epineurium-perineurium tube which contained many minute fascicles of regenerated nerve fibers. The newlyformed epineurium-perineurium tubs rejoined ths two stumps of the transected epineurium theath perineurium tube. The healing process of the nerve fascicle after crushing was similar to that after transection and suturing.From the transection and suturing of the nerve to the formation of the new epineurium-perineurium tubs the sequence of pathological events occurring in the epineurium and perineurium could be divided into 3 stages, the first stage of trau-matic inflammation, degeneration and necrosis of the perineurium, the second stage of perineurial cell proliferation, and the regeneration nerve fiber growth into the pre-perineurium mass and the third stage of the formation of new small nerve fascicles.The formation of the new epineurium-perineurium tube is of vital importance to nerve regeneration, it can prevent the nerve fibers from growing astray and guide them to the distal perineurium tube. The pro-perineurial cells might originate from the proliferation of the perineurial cells, themselves.The normal histological and ultrastructural morphology of the rab bit sciatic nerve was described. The nuclei of the perineurial cells have the tendency to form palisades. It seems that this may explain the palisading of the nuclei of neurofibr-oma cells.