摘要
目的：探索周围神经对扩张延长的耐受性．方法：设计出适合神经延长的组织扩张器，对兔坐骨神经缓慢扩张延长（共２１天），观察神经内的微循环、血－神经屏障、神经功能、形态学及超微结构变化．结果：延长率小于２０％时，神经内循环血量增加，血管增多、变粗，神经功能及形态无变化．延长率２０％～４０％时，血流量回落，４５％时到正常水平，主要是神经束内血流量减少．此后，随着延长量增加，束外血流量亦减少，神经纤维波状弯曲减少或消失，部分粗纤维出现脱髓鞘变，神经传导功能下降，但细纤维一直保持完好．延长率大于７０％后，血－神经屏障功能受到损害．结论：兔坐骨神经对缓慢扩张延长有较好的耐受性，延长率小于４０％较为安全．神经在扩张过程中，微循环首先受到影响，继之出现形态及功能的改变．神经微循环血量降低，尤其是束内血流量降低，是制约神经延长的主要因素．
Aim: To study the peripheral nerve endurance to expansion. Methods: The rabbit sciatic nerves were expanded slowly (for 21 days) with a tissue expander designed by ourselves. The changes of microcirculation, blood nerve barrier, physiological function, morphology and ultrastructure of the expanded nerve were observed systematically. Results: The elongation less than 20% made the nerve microangium grow in number and in diameter, and microcircuatory perfusion increase. No apparent changes occurred in nerve function and morphology. With 20% 40% of elongation, the blood perfusion came back rapidly, and reached normal with 45% of elongation mainly due to the decrease of blood flow inside fasciculus. As the nerve was elongated, the blood perfusion both inside and outside fasciculus decreased, and the nerve function and morphology changed apparently and gradually. The undulation of nerve fibers was reduced or eliminated, the degeneration of some thick fibers occurred and conduction function decreased. The thin fiber kept intact continuously. The function of blood nerve barrier was destroyed with more than 70% of elongation. Conclusion: The sciatic nerve of rabbits could better tolerate slow expansion. The elongation less than 40% is safe. The microcirculation was first influenced and the changes occurred in physiology function and morphology of the nerve in the process of further expansion. The decrease of nerve microcirculation, especially inside the fasciculus, is the important factor in limiting nerve elongation.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
1997年第5期291-294,共4页
Chinese Journal of Trauma
关键词
周围神经
神经缺损
神经扩张
组织扩张器
Peripheral nerve Nerve gap Nerve expansion Nerve elongation Tissue expander
