周围神经火器伤海水浸泡后大鼠神经损伤区域改变及手术处理体会

目的 研究火器性周围神经损伤并海水浸泡后神经及邻近损伤处的病理学变化,为临床火器伤周围神经损伤的救治提供实验依据.方法 180只SPF级SD大鼠按数字表法随机分为5组:大鼠坐骨神经火器伤(非完全断裂损伤)海水浸泡模型组(A1组),大鼠坐骨神经火器伤(完全断裂损伤)海水浸泡模型组(A2组),大鼠坐骨神经火器伤(非完全断裂损伤)模型组(B1组),大鼠坐骨神经火器伤(完全断裂损伤)模型组(B2组),大鼠坐骨神经锐性切断处理组(C组),致伤后对坐骨神经行大体形态学观察和病理学观察.结果 A1组神经纤维断裂,外膜及束膜下毛细血管断裂,可见大片灶状出血;A2组神经内可见大量神经纤维断裂,外膜及束膜下广泛出血,髓鞘断裂.B1组、B2组与A1组、A2组镜下观察所见相似.C组未见明显神经纤维断裂,神经外膜、束膜完整.随着时间的延长,A1组、A2组、B1组、B2组损伤神经束内出现严重水肿,大量白细胞浸润.在各个时间点A1组、A2组水肿程度均较B1组、B2组轻.结论 与B1组、B2组相比,A1组、A2组神经纤维损伤情况相似,炎性细胞浸润较严重,神经外膜及束膜水肿B1组、B2组稍轻.

Changes in peripheral nerve damage area after firearm injury coupled with seawater immersion and personal experience of surgical treatment in rats

Objective To explore pathological changes in peripheral nerve damage area after firearm injury coupled with sea -water immersion, so as to provide experimental evidence for clinical treatment of peripheral nerve firearm injuries .Methods One hun-dred and eighty SPF SD rats were randomly divided into 5 groups, i.e.the firearm sciatic nerve injury ( incomplete breaking injury ) coupled with seawater immersion rat model group ( or group A1 ) , the firearm sciatic nerve injury ( complete breaking injury ) coupled with seawater immersion rat model group (or group A2), the firearm sciatic nerve injury (incomplete breaking injury) rat model group (or group B1), the firearm sciatic nerve injury (complete breaking injury) rat model group (or group B2), and the sharply-severed sciatic nerve group (or group C).Observations were made on gross morphology and pathology following sciatic nerve injury .Results In group A1, nerve fibers were totally broken , capillaries beneath epineurium and perineurium were ruptured with multifocal hemor -rhage.In group A2, many nerve fibers were broken , with extensive hemorrhage beneath epineurium and perineurium and myelin was al -so ruptured.Microscopy showed that damages similar to those of group A1 and group A2 could be observed in group B1 and group B2. No significant nerve fiber rupture was observed in Group C , and epineurium and perineurium remained intact .With the extension of time, severe nerve tract edema was observed in group A1, group A2, group B1 and group B2, with the infiltration of large quantities of leukocytes.At all the time points,the degree of edema for group A1 and group A2 were obviously less severe than that of group B1 and group B2.Conclusion Nerve fiber damage was identical in group A1 and group A2, with severe inflammatory cell infiltration and less severe in the edema of epineurium and perineurium , as compared with those of group B1 and group B2.