【摘要】 目的:通过小间隙自体静脉桥接的吻合方法行副神经移位修复颈5、上干,以了解副神经移位修复颈5、上干及节省动力神经源的可行性。方法:40只雄性Wister大鼠,随机分成两组,A组,近椎间孔处将颈5、6神经根切去约1.5mm,颈6两端和颈5近端结扎;B组,剪除颈5、6、7神经根,颈5、6近端和颈7两端结扎。两组均以自体颈静脉桥接分别行副神经小间隙(2mm)吻合于颈5和上干。两组的左侧为对照侧。术后12周行三角肌和肱二头肌电生理学检查。结果:A组三角肌和肱二头肌的复合动作电位(CMAP)波幅和潜伏期左右侧差异无显著性(P>0.05);B组肱二头肌CMAP波幅和潜伏期左右侧差异无显著性(P>0.05),三角肌CMAP波幅和潜伏期左右侧差异有显著性(P<0.05)。结论:副神经移位修复颈5后肱二头肌和三角肌功能恢复良好。而修复上干肱二头肌功能恢复较好;三角肌亦有恢复,但电生理结果在统计学上差异有显著性。更多还原

【Abstract】 Objective To observe the feasibility of repairing C5 and superior trunk and saving power nerve source with accessory nerve transposition performed by using small gap autogenous vein bridging anastomosis. Methods Forty Wister male rats were randomly divided into two groups, including group A:1.5 mm of the 5th and 6th cervical nerve roots were cut off near the intervertebral foramen and both ends of the 6th cervical nerve root and the proximal end of the 5th cervical nerve root were ligated, and group B: the 5th, 6th and 7th cervical nerve roots were cut off and the proximal end of the 5th and 6th cervical nerve roots and both ends of the 7th cervical nerve root were ligated. In both groups, the accessory nerve was respectively anastomosed to the 5th cervical nerve root and superior trunk with small gap (2 mm) using autogenous jugular vein bridging. The left side of the same rat was the control side. Twelve weeks after surgery, the electrophysiological detection of the musculus deltoideus and musculus biceps brachii was performed. Results In group A, there was no significant difference(P >0.05) between the left side and right side in the musculus deltoideus or musculus biceps brachii compound motor action potential (CMAP) amplitude and latent period; in group B, there was no significant difference(P >0.05) between the left side and right side in the musculus biceps brachii CMAP amplitude and latent period, but there was a significant difference (P< 0.05) between the left side and right side in the musculus deltoideus CMAP amplitude and latent period. Conclusions Functional recovery of musculus deltoideus and musculus biceps brachii can be well achieved after repairing the 5th cervical nerve using accessory nerve transposition. Repairing the superior trunk leads to better funtional recovery of the musculus biceps brachii and the some functional recovery of musculus deltoideus, but there is the statistical significance of difference between them.更多还原