膈神经、副神经转位重建大鼠股四头肌功能的实验研究

目的 应用三级SD大鼠膈神经、副神经转位桥接尺神经修复股神经,观察此手术对重建大鼠股四头肌功能的疗效.方法 大鼠20只,随机分为A、B两组,每组10只.A组:左侧行膈神经桥接带血管蒂的尺神经转位修复股神经手术,右侧切断神经不吻合,作空白处理.B组:左侧行副神经桥接带血管蒂的尺神经转位修复股神经手术,右侧切断神经不吻合.A、B两组于24周后观察股四头肌电生理、有髓神经纤维通过率及截面积、股四头肌湿重比、肌纤维截面积比等指标.结果 A组与B组比较:肌肉复合动作电位波幅[(17.55±0.69)vs(15.48±0.66)]、股四头股湿重比[(2.0199±0.0698)vs(1.9527±0.0271)]、肌纤维截面积比[(2.108±0.027)vs(1.990±0.076)]差异有统计学意义(P＜0.05或0.01);两组有髓神经纤维通过率、截面积比较差异无统计学意义(P＞0.05).结论 大鼠隔神经、副神经通过桥接尺神经移位吻合至股神经,可恢复股四头肌部分功能,用膈神经转位疗效较好.

Reconstruction of quadriceps femoris muscle by transposition of phrenic nerve and accessory nerve in rats

Objective To observe the effect of transferring phrenic nerve or accessory nerve to femoral nerve on the reconstruction of quadriceps femoris muscle in rats.Methods Twenty SD rats were randomly divided into two groups.The left phrenic nerve or accessory nerve was transferred to femoral nerve by the vascularized ulnar nerve bridging in Group A and Group B,whereas the right femoral nerve remained the disjunction.The electromyogram and wet weight,throughput and section area of myelinated nerve fibers,and section area of muscle fibers in quadriceps femoris muscle were determined after 24 weeks.Results The amplitude of compound muscle action potential,the ratio of section area of muscle fibers,and the ration of wet weight in quadriceps femoris muscle in Group A were superior to those in Group B(P<0.01-0.05),but there was no significant difference in the throughput and section area of myelinated nerve fibers between both groups (P>0.05).Conclusion The transfer of either phrenic nerve or accessory nerve to femoral nerve through the vascularized ulnar nerve bridging can improve the movement and sensation of quadriceps femoris muscle in rats,especially by the transfer of phrenic nerve.