许建中 李起鸿 廖维宏 许建中、李起鸿 400038 重庆，第三军医大学西南医院骨科；廖维宏 第三军医大学野战外科研究所三室 中华骨科杂志 1999 0 19 3


    关键词：骨延长术；周围神经；血循环 期刊 zhgkzz 0 基础研究 fur -->


    

【摘要】目的 动物活体测试表明急性牵伸周围神经6%～8%时血供明显减少，12%～15%时血流停滞。但缓慢牵伸肢体延长时，延长幅度可远远超过周围神经的生理弹性限度而无神经功能受损。本课题研究缓慢牵伸肢体延长对兔胫后神经血循环的影响。方法 采用兔后肢延长模型，按胫骨延长幅度分为10%、20%、30%及40%四组，24只用于墨汁灌注胫后神经血管形态观察。22只用于氢气清除法胫后神经血流量测定。结果 随着肢体延长量的增加，胫后神经血管逐渐变直，但血管密度及面积明显增加。图像分析显示延长区及其远、近端的血管面积均明显大于健侧对照。切片观察束内毛细血管充盈良好。氢气清除法血流量测定不同延长组间及与正常对照组间差异无统计学意义。结论 周围神经的血循环逐渐适应缓慢的牵张应力，从而使之在肢体延长的过程中避免缺血性损害，为神经的再生修复提供血供保障。

    A Study on the Adaptive Mechanism of Peripheral Nerve to Gradual Limb Lengthening in Rabbits： Observation of Blood Supply

XU Jianzhong ^* , LI Qihong, LIAO Weihong.

    ^* Department of Orthopaedics, Southwest Hospital, The Third Military Medical University, Chongqing 400038

【 Abstract 】Objective To evaluate the effect of limb lengthening on the blood circulation of posterior tibial nerve in rabbits. Methods The tibial lengthening operation was performed in rabbit and created as the gradual stretching model of 10% , 20% , 30% and 40% . Twenty-four animals were used for the morphological observation of blood vessels in the posterior tibial nerve by filling of Chinese ink, and 22 for the determination of regional blood flow by Hydrogen clearance method (HCM). Results It was found that, as lengthening proceeded, that the waved shape of blood vessels was straightened, both the transverse and oblique branch became parallel to the nerve trunk, the density and diameter of the blood vessels were increased. Image analysis indicated that the distribution of blood vessels in proximal, lengthened and distal parts of posterior tibial nerve were all higher than that of normal control. Pathological section also revealed that the endoneurial capillary was well filled. The blood flow rate by HCM in different lengthening groups has no significant difference compared with normal control. Conclusion The results demonstrated that the blood circulation of peripheral nerve could adapt to the gradual tension force, so that ischemic damage might be avoided during limb lengthening. On the other hand, the synchronous regeneration of peripheral nerve is provided by rich blood supply.

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