【作者】 陈亮；

【导师】 顾玉东； 陈德松； 徐建光； 成效敏；

【作者基本信息】 上海医科大学 ， 显微外科， 1998， 博士

【摘要】 我们的临床实践及实验研究已经证明健侧颈神经根移位是治疗臂丛根性撕脱伤的有效方法，且颈7切断不造成健侧肢体的功能损害。由于全臂丛根性撕脱伤患者可同时伴副神经、膈神经及肋间神经损害，故从健侧发现更多潜在的移位神经是恢复患肢功能的有效途径。本实验的目的在于研究除颈7以外，其他单一臂丛神经根切断是否会造成肢体功能的损害。若切断单一神经根不造成肢体损害，那么切断相邻或不相邻两根颈神经以致三根颈神经对肢体功能影响如何，即阐明维持一侧肢体正常功能到底至少需要多少神经根，从而为健侧臂丛神经根充分及合理的应用奠定理论基础。 第一部分 大鼠前肢周围神经及主要肌肉的中枢及背根神经节定位 目的：研究大鼠颈5-胸1神经根的外周代表神经及代表肌肉，为颈5～胸1神经根不同方式切断后的功能检测提供准确的被检神经与肌肉。 材料与方法：40只SD大鼠(体重150～200克)随机等分成正中、尺、桡、肌皮、腋神经及三角肌、肱二头肌、伸指总肌、屈指深肌及爪内肌共10组。用1％硫喷妥钠(0.6～0.8ml)腹腔麻醉后，在手术显微镜下前肢切口内(每组左右各2只)分别游离出上述周围神经及肌肉，用微量进样器于神经外膜下缓慢推注辣根过氧化酶(HRP)7ul(结合型)；肌肉注射作多点进针以使溶液均匀吸收。存活4天后按HRP常用方法灌注固定，取出C4-T2脊髓及相应背根神经节(仅限于神经组)，清洗过夜(4℃)。材料作冰冻连续横切片，厚50um。脊髓节段每10张连续切片取1张共6张，神经节取最大断面3张。用Morrell的TMB法做蓝色反应。贴片、中更多还原

【Abstract】 Part one: Certral and dorsal root ganglion location of peripheral nerves and main muscles in ratsObjective: To study the representative peripheral nerves and muscles of C5-T1 nerve roots of the brachial plexus in the rat, to provide sound nerves and muscles for determining limb function after related nerve root division.Material and method: Forty rats weighing between 150 and 200g were randomly divided into ten groups of four each. The spinal centre and corresponding dorsal root ganglion location of the axillary, musculocutaneous, radial, median, and ulnar nerves of the rat was investigated respectively in the former five groups using the retrograde horseradish peroxidase(HRP) method. The spinal centre location of the deltoid, the biceps, the extensor digitorum communis, the flexor digitorum profundus and intrinsical muscles of the anterior paw was studied with the same method in the latter five groups. HRP of combined pattern(7μl)was injected under the epineurium of the nerve, and in the muscle by multiple points. After survival for 4 days, the C4-T2 spinal cord and corresponding dorsal root ganglions were taken and consecutive frozen sections were made. The number of HRP-labelled cells of spinal anterior horn and dorsal root ganglions were counted with the use of biological microscope.更多还原