不同吻合面积影响神经端侧吻合法修复效果的实验研究

目的比较神经端侧吻合处不同接触面积对周围神经端侧吻合后神经再生的影响，观察面积因素在神经端侧吻合法中的作用。方法选用50只健康SD大鼠，采用右侧腓总神经损伤修复模型。术中根据手术修复方法不同，分为A、B两组，每组25只。每组将右侧腓总神经在其坐骨神经分支后3mm处局部封闭，利刀切断，吻合于胫神经。A组神经远断端切成45°斜面，腓总神经与胫神经端侧吻合；B组神经远断端切成10°斜面，腓总神经与胫神经行端侧吻合。术后第8周分别对三组大鼠进行组织形态学、腓肠肌湿重检测、肌电图、有髓神经纤维计数和神经示踪法观察。结果B组肌湿重检测、肌电图、有髓神经纤维计数检测指标在8周时与A组比较，各项检测指标均存在明显差异（P〈O．05）。结论增大神经断端接触面积后行神经端侧吻合法修复神经，神经纤维再生良好；增大神经断端接触面积能获得更有效的神经再生；长人远端的神经纤维多少与受端吻合接触面积大小有关。

The Effect of Different Anastomotic Area in End-to-side Neurorrhaphy for Peripheral Nerve Injuries .An Experimental Study

Objective To study and compare the effect of different anastomotic area in end-to-side neurorrhaphy on rat peripheral nerve injuries repairing modelMethods 50 rats were randomized into 2 groups（A,B,n=25）. In all groups,the peroneal nerve was transected and sutured in an end to-side model. In A group,the distal end of the in- jured peroneal nerve was operated in an angle of 45 degrees ;in t3 group,the distal end was operated in an angle of 10 degrees, and sutured in end-to-side neurorrhaphy to the donor nerve. Histological, electromyographie, muscle wet weight were analyzed. Myelinated nerve counts and Neuronal tracing with Dil were performed at the end of 8 weeks post operation. Results In B group, the muscle net weight, electromyography, myelinated nerre counts were per- formed than them in A group. The difference is significant（P（0. 05）. Conclusion The larger Anastomotic area end- to-side neurorrhaphy can enhance axonal sprouting from the donor nerve,and improve the functional recovery. The anastomotic area is the important factors to the end-to-side coaptation model.