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同侧颈7神经根移位治疗臂丛上干根性撕脱伤的实验研究
  • ISSN号:0529-5815
  • 期刊名称:《中华外科杂志》
  • 时间:0
  • 分类:R651.3[医药卫生—临床医学;医药卫生—外科学] R622.3[医药卫生—整形外科;医药卫生—临床医学;医药卫生—外科学]
  • 作者机构:[1]复旦大学附属华山医院手外科,上海200040
  • 相关基金:国家自然科学基金资助项目(30471743);国家重点基础研究发展计划资助项目(973项目:2003CB515305)
中文摘要:

目的 实验性比较同侧C7神经根全根移位与其他3种方法治疗臂丛上干根性撕脱伤的疗效。方法120只SD大鼠建立上干根性撕脱伤模型后随机等分为4组,每组30只。(1)A组:同侧C7移位至上干+副神经至肩胛上神经;(2)B组:Oberlin手术(尺神经一束移位至肱二头肌支)+副神经至肩胛上神经+桡神经肱三头肌长头支至腋神经前支;(3)C组:膈神经移位至上干前股+副神经至肩胛上神经+颈丛运动支至上干后股;(4)D组:膈神经移位至上干前股+副神经至肩胛上神经,不作腋神经修复。术后3、6和12周每组取10只大鼠作Ochiai评分、Barth足错步试验、Terzis梳头试验及神经再生指标的检测。结果术后3周,A组3项行为学检测指标与3个对照组差异无统计学意义(P〉0.017),腋神经电生理指标均显著优于3个对照组,其余各项腋神经及三角肌组织学指标均显著优于C组和D组,但与B组比较差异无统计学意义。A组除肌皮神经再生有髓神经纤维通过率显著优于C组外,其余肌皮神经及肱二头肌的电生理与组织学检测指标与3个对照组比较差异无统计学意义。12周时,A组各项行为学观察、几乎全部腋神经和三角肌的电生理与组织学检测以及部分肌皮神经和肱二头肌的电生理与组织学检测指标均已显著优于3个对照组。结论同侧C7神经根移位对治疗臂丛上干根性撕脱伤的实验性疗效显著。

英文摘要:

Objective To experimentally compare the treatment outcome of the injured upper limb of the root avulsion of C5 and C6 of the brachial plexus repaired by ipsilateral C7 nerve root transfer and other three multiple nerve transfers. Methods One hundred and twenty SD rats of simulated C5 and C6 root avulsion randomly divided into 4 groups, and 30 each underwent various combined nerve transfers. Group A : the ipsilateral C7 root transferred to the upper trunk of brachial plexus and the spinal accessory nerve to the suprascapular nerve; Group B: partial fascicles of the ulnar nerve transferred to the biceps branch (Oberlin' s procedure), the spinal accessory to-the suprascapular and branches to the triceps long head to the axillary nerve; Group C: the phrenic transferred to the musculocutaneous, cervical plexus motor branches to the lower trunk( axillary nerve) of brachial plexus and the spinal accessory nerve to the suprascapular nerve; Group D: the phrenic transferred to the musculocutaneous and the spinal accessory nerve to the suprascapular nerve. Neurotization outcomes were evaluated at 3, 6 and 12 weeks postoperatively by comparing changes of behavioral tests (Ochiai clinical scores, Barth Foot-fault test and Terzis grooming test), neurophysiological investigations and muscular histology. Results At 3 weeks after operation, no significant difference was found between Group A and other three control groups in the three behavioral evaluations. Neurophysiologic investigations of the axillary nerve showed that Group A was superior to the other three groups. Muscular histological outcome of the axillary nerve and deltoid muscle showed that Group A was superior to the Group C and D, while no significant difference was found between Group A and B. Except that the thruput of regenerating medullated musculocutaneous nerve fibers of Group A was superior to Group C, neurophysiological and histological outcome of the musculocutaneous nerve and biceps showed that no significant difference was found betwe

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期刊信息
  • 《中华外科杂志》
  • 中国科技核心期刊
  • 主管单位:中国科学技术协会
  • 主办单位:中华医学会
  • 主编:赵玉沛
  • 地址:北京市东四西大街42号
  • 邮编:100710
  • 邮箱:cmacjs@cma.org.cn
  • 电话:010-85158180
  • 国际标准刊号:ISSN:0529-5815
  • 国内统一刊号:ISSN:11-2139/R
  • 邮发代号:2-59
  • 获奖情况:
  • 1997年三部委评选第二届全国优秀科技期刊三等奖、...,1999年首届国家期刊奖、2002年第二届国家期刊奖,2000年获国家自然科学基金资助期刊
  • 国内外数据库收录:
  • 美国化学文摘(网络版),荷兰文摘与引文数据库,美国生物医学检索系统,日本日本科学技术振兴机构数据库,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2011版),中国北大核心期刊(2014版),中国北大核心期刊(2000版)
  • 被引量:77672