兔面神经部分缺损两端不同幅度延长对修复效果影响.docVIP

兔面神经部分缺损两端不同幅度延长对修复效果影响 兔面神经部分缺损两端不同幅度延长对修复效果的影响 更新日期：2011-06-16 牙祖蒙　陈宗基　王建华　李忠禹　谭颖徽 　　【摘要】　目的　观察面神经缺损两端不同幅度延长对修复效果的影响。　方法　于中点切断兔面神经颊支，断点近、远段均以10 mm/10 min的速度分开延长，延长幅度分别为神经全长的0％、10％、20％、30％、40％，按正交设计法配伍；延长结束后缝合神经端端外膜，近、远端延长幅度均为0%组则切除10 mm神经再回植，作为对照；第12周用肌电图、神经传导速度及组织病理改变评价修复效果。　结果　不管远段延长幅度如何，只要近段延长大于30％，都明显影响修复效果；而近段延长幅度小于30％，远段延长达40％，修复效果仍不受明显影响。　结论　(1)面神经快速延长术是可行的；(2)神经缺损两端的延长幅度直接影响修复效果，近段延长应小于30％，而远段可延长到40％，可获同神经移植相近的疗效。 　　【关键词】　缝合技术，周围神经；　面神经；　周围神经延长术 Experimental study of effects of elongation of proximal and distal segments of transected facial nerve on defect repair YA Zumeng, CHEN Zongji, WANG Jianhua, et al. Stomatologic Department, Xinqiao Hospital, The Third Military Medical University. Chongqing 400037, China 　　【Abstract】　Objective　To investigate the effects of elongation of proximal and distal segments of facial nerve on the result of defect repair. 　Methods　 Buccal branches of rabbit facial nerves were transected medially. With the expander designed by the authors, the proximal and distal nerve segments were lengthened separately. The elongation speed was 10mm per 10 minutes . According to the principle of orthogonal design , both the proximal and distal segments of 25 branches were lengthened up to 0%, 10%, 20%, 30%, 40%, respectively . When the elongation was completed, end to end repairs were performed. In the control group both proximal and distal segments were not lengthened (0%), 1cm segment of the nerve was cut off and then replanted. Electromyogram(EMG) of buccal muscle and nerve conductive velocity(NCV) were measured at 12 weeks to evaluate the function of the repaired nerves, and the number and diameter of regenerationed fibers were counted. 　Results　So long as the proximal segments were lengthened over 30% the evaluated parameters were significantly lower than the replantation group, and when the proximal segments were elongated within 30% , the distal segments could be lengthened up to 40% without significant decrease in the function