膈神经端侧吻合迷走神经重建高位颈髓损伤后呼吸功能的研究-外科学(骨科)专业论文.docxVIP

第二军医大学博士学位论文 第二军医大学博士学位论文 膈神经端侧吻合迷走神经重建高位颈髓损伤后呼吸功能的研究 膈神经端侧吻合迷走神经重建高位颈髓损伤后呼吸功能的研究 - - PAGE 10 - - - PAGE 13 - 五、5只大鼠中有3只大鼠染色较清晰，一只未染色，一只染色较差。CB－HRP的 反应产物在明亮视野下呈青兰色，标记的细胞和轴突的形态显示良好。逆行标记的细 胞胞体和树突中的产物呈颗粒性，在疑核中，反应产物呈均质性或排列极为密集的小 颗粒，神经元胞体结构清晰，标记轴突内的产物也为均质性。 结论： 颈部迷走神经与膈神经位置较近，相对表浅易暴露，且迷走神经内运动神经纤维 含量与膈神经相似，适宜吻合。膈神经端侧吻合迷走神经后，膈神经纤维能较好的再 生，并建立膈神经－迷走神经－疑核通路，有效的维持高位颈髓损伤大鼠的呼吸功能。 关键词：迷走神经；膈神经；脊髓损伤；呼吸功能；神经移位；端侧吻合 Objectives: Abstract To provide anatomic details on the vagus nerve and phrenic nerve for neuritisation in patients with high spinal cord injuries. To count of motor neurofibra employing the techniques of immunohistochemistric staining. To find the proper area in which the anastomosis of phrenic nerve and vagus nerve by end to side. To establish the experimental model of the respiratory function reconstruction in the rats with upper cervical cord injuries through transposition of vagus nerve and phrenic nerve reconstruction. The function testing method of the diaphragm is adopted to measure the motion function of the diaphragm postoperatively. To study the features of the EMG of the diaphragm after the respiratory function reconstruction in the rats with upper cervical cord injuries through transposition of vagus and phrenic nerve reconstruction. To study the features of the blood gas changes after the respiratory function reconstruction in the rats with upper cervical cord injuries through transposition of vagus nerve and phrenic nerve reconstruction. To find the relationship between phrenic nerve and ambiguous nucleus after the transposition of vagus nerve and phrenic nerve by the technique of CB-HRP retrograde labeling. To investigate the feasibility of respiratory function reconstruction through the transposition of vagus nerve and phrenic nerve in the rats with upper cervical cord injury. New method can be adopted to reconstruct the respiratory function in the patients with upper cervical cord injury in the clinical practice. Methods 20 cadavers were dissected in