健侧颈7移位术治疗中枢神经损伤后上肢功能障碍的实验研究

摘要

Objective To investigate the feasibility of treating dysfunction in the forearm following central nervous system injury using contralateral C7 nerve transfer in rodent models.Methods Twenty-four female Sprague Dawley(SD)rats were studied.They were randomly divided into three groups:(A)the normal control group(n =8);(B)the group with a unilateral(left)motor cortex aspiration(n =8);(C)the group with a unilateral(left)motor cortex aspiration and contralateral(left)C7 nerve transfer to the paralyzed(right)side(n =8).The extent of injury and functional recovery of the paralyzed upper limb was evaluated preoperatively and 2,4,6,8 weeks and 3,5,7,10,12 months postoperatively using behavioral tests such as skilled reaching task and limb-use asymmetry test.Results All the rats in the two experimental groups showed spontaneous functional improvement postoperatively.By 3 months after the operation,the transferred contralateral C7 nerve reached the target muscles and the rats began to demonstrate superior functional recovery to the animals with unilateral(left)motor cortex aspiration only.At the end of 7 months postoperatively,the motor recovery of the paralyzed forearm plateaued.There were significant differences among the three groups(P ＜ 0.01),while Group C revealed significantly better results comparing to Group B.Conclusion Contralateral C7 nerve transfer is an effective method for the treatment of forearm dysfunction following central nervous system injury in rats.%目的 研究成年大鼠健侧颈7(C7)神经移位治疗中枢神经损伤后一侧上肢感觉运动功能障碍的可行性.方法 取清洁级雌性SD大鼠24只,随机分成3组,即健康对照组(n=8)；脑外伤模型组(n=8)；脑外伤+健侧颈7神经根移位至瘫痪侧颈7神经根组(n=8).分别于术前、术后2周、4周、6周、8周、3个月、5个月、7个月、10个月、12个月,采用抓取实验、肢体不对称实验等动物行为学方法,评价大鼠瘫痪上肢损伤程度及功能恢复情况.结果 术后行为学结果显示,术后不同时间各实验组大鼠瘫痪上肢功能均有一定程度的自发性恢复.术后3个月健侧颈7神经移位组大鼠瘫痪上肢功能优于脑外伤模型组.术后7个月,各实验组大鼠瘫痪肢体功能恢复趋于稳定,三组比较差异有统计学意义,C组优于B组.结论 健侧颈7移位术治疗中枢神经损伤上肢功能障碍是可行、有效的.