经皮电刺激对端侧缝合后神经再生作用的研究

摘要

目的　研究经皮电刺激（transcutaneous electrical nerve stimulation,TENS）对周围神经端侧缝合后促神经再生的作用。方法　18只健康白兔按取材时间的不同随机分为A、B、C 3组，白兔双侧腓总神经切断后与同侧外膜开窗的胫神经作端侧缝合。左后肢为实验侧，术后给予TENS，共用6周。右后肢不给电刺激，做为对照侧。分别于术后3、6、16周取材，进行大体观察、神经组织学、电生理、透射电镜和胫前肌肌湿重检查。 结果　各组实验侧腓总神经有髓纤维数、运动神经传导速度、肌肉复合电位(CMAP)波幅和胫前肌肌湿重均高于对照侧(P ＜ 0.05)。实验侧腓总神经髓鞘成熟程度优于对照侧。结论　TENS在提高神经端侧缝合后侧支萌出率和减轻失神经肌肉萎缩方面有积极的作用。%Objective　To study the effect of transcutaneous electrical nerve stimulation(TENS) on peripheral nerve regeneration after end - to - side neurorrhaphy. Methods　18 rabbits were randomly divided into three groups. The common peroneal nerve on both sides was transected and then its distal end sutured to the tibial nerve with epineural window in an end - to - side fashion. TENS was given to the left hindlimb postoperatively for 6 weeks. The right hindlimb served as control without electrical stimulation. Gross appearance observation, histological, electrophysiological, and transmission electron microscopic examination, and anterior tibial muscle wet weight measurement were carried out at 3, 6 and 16 weeks postoperatively. Results　Compared with the control side, the experimental side had more regenerating myelinated nerve fibers, faster motor nerve conduction velocity, higher amplitude of composite muscle action potential, and heavier anterior tibial muscle wet weight. The maturity of myelin sheath of the common peroneal nerve was also superior. Conclusions 　TENS had beneficial influence on promoting peripheral nerve collateral sprouting after end - to - side neurorrhaphy and reduce denervation muscle atrophy.