【摘要】：目的:本實(shí)驗(yàn)旨在探尋阿司匹林是否對(duì)周?chē)窠?jīng)損傷恢復(fù)具有促進(jìn)作用。方法:雄性SD大鼠30只,體重在200-220克,隨機(jī)分為阿司匹林組及生理鹽水組。所有大鼠左側(cè)坐骨神經(jīng)完全離斷,10倍顯微鏡下行神經(jīng)吻接術(shù),實(shí)驗(yàn)組給予阿司匹林溶液(10mg/ml、50mg/kg)灌胃,1次/日,對(duì)照組給予等量生理鹽水灌胃。術(shù)后觀察大鼠大體精神狀態(tài)、飲食情況及展爪反射等指標(biāo);術(shù)后第2、4、6、8周分別計(jì)算兩組大鼠坐骨神經(jīng)功能指數(shù)(SFI);術(shù)后第2、4、6周分別測(cè)量感覺(jué)神經(jīng)再生距離(Pinch test);術(shù)后第2、4、6、8周分別取大鼠雙側(cè)腓腸肌,稱(chēng)重并計(jì)算肌肉濕重比;術(shù)后第6、8周分別取腓腸肌固定、染色,Olympus軟件下測(cè)量直徑;術(shù)后第8周測(cè)量大鼠坐骨神經(jīng)傳導(dǎo)速率、潛伏期、波幅、并計(jì)算傳導(dǎo)速度恢復(fù)率;術(shù)后第4、8周分別取大鼠左側(cè)坐骨神經(jīng)行免疫組化S-100抗體染色,應(yīng)用Olympus軟件并計(jì)算單位視野中雪旺細(xì)胞的數(shù)量并進(jìn)行統(tǒng)計(jì)學(xué)分析;術(shù)后第8周電鏡下觀察雪旺細(xì)胞增生情況及神經(jīng)髓鞘排列變化情況。結(jié)果:大體觀察:阿司匹林組的精神狀態(tài)、飲食狀況相比于對(duì)照組更佳。阿司匹林組大鼠展爪反射、分趾功能恢復(fù)較早,約在術(shù)后3~4周,對(duì)照組展爪反射出現(xiàn)較晚,約術(shù)后第6周有所改善;術(shù)后第4周可見(jiàn)生理鹽水組神經(jīng)吻合口遠(yuǎn)端神經(jīng)較近端變細(xì),神經(jīng)彈性減弱,吻合口未見(jiàn)明顯血管通過(guò),阿司匹林組可見(jiàn)神經(jīng)吻合口有少量血管通過(guò),神經(jīng)彈性良好,遠(yuǎn)端神經(jīng)較近端神經(jīng)直徑并無(wú)明顯差異;坐骨神經(jīng)功能指數(shù)(SFI):術(shù)后2周,因大鼠術(shù)側(cè)足趾攣縮,自然下垂,足爪不能展開(kāi),無(wú)法支撐著地,坐骨功能指數(shù)不能檢測(cè)。術(shù)后第4、6、8周阿司匹林修復(fù)組坐骨神經(jīng)指數(shù)優(yōu)于生理鹽水組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);感覺(jué)神經(jīng)再生距離(Pinch test):阿司匹林組較生理鹽水組恢復(fù)距離更長(zhǎng),差別具有統(tǒng)計(jì)學(xué)意義(P0.05);腓腸肌肌濕重比恢復(fù)率除第2周無(wú)統(tǒng)計(jì)學(xué)差異外,4、6、8周阿司匹林組均優(yōu)于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后6、8周腓腸肌直徑阿司匹林組均大于同期生理鹽水對(duì)照組,差異具有統(tǒng)計(jì)學(xué)差異(P0.05);神經(jīng)電生理檢測(cè):阿司匹林組潛伏期低于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),阿司匹林組波幅高于對(duì)照組,差別具有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組傳導(dǎo)速度快于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)差異(P0.05);免疫組織化學(xué):術(shù)后第4、8周阿司匹林組S-100蛋白表達(dá)及分布情況均優(yōu)于同時(shí)期生理鹽水組,實(shí)驗(yàn)組較對(duì)照組雪旺細(xì)胞增生明顯且具有統(tǒng)計(jì)學(xué)意義(P0.05);電鏡顯示:阿司匹林組神經(jīng)髓鞘厚度高、外形規(guī)則呈圓形或橢圓形,阿司匹林組具有完整鞘膜的神經(jīng)纖維,鞘膜增厚,排列較整齊,阿司匹林組髓鞘板層分布較好,厚度較均勻,排列整齊,對(duì)照組神經(jīng)纖維板層略疏松,髓鞘扭曲明顯,厚度不一,形狀不規(guī)則。結(jié)論:阿司匹林具有促進(jìn)周?chē)窠?jīng)損傷修復(fù)作用
[Abstract]:Objective: to explore whether aspirin can promote the recovery of peripheral nerve injury. Methods: thirty male SD rats, weighing 200-220 g, were randomly divided into aspirin group and saline group. The left sciatic nerve of all rats was completely disconnected, and the nerve anastomosis was performed under 10 times microscope. The experimental group was given aspirin solution (10 mg / ml 50 mg / kg) once a day, and the control group was given the same amount of normal saline. After operation, the general mental state, diet and paw reflex of rats were observed. The sciatic nerve function index (SFI);) of the two groups was calculated at 6 weeks after operation, and the sensory nerve regeneration distance (Pinch test);) was measured at 6 weeks after operation. The bilateral gastrocnemius muscles were taken from rats at the 2nd week and 4th week after operation, and the muscle wet weight ratio was calculated, and the gastrocnemius muscle was fixed, stained, and the diameter was measured by Olympus software at the 8th week after the operation, the gastrocnemius muscle was fixed, stained, and the diameter was measured by Olympus software. The conduction rate, latency and amplitude of sciatic nerve were measured at the 8th week after operation, and the recovery rate of conduction velocity was calculated. The left sciatic nerve of the rats was harvested for S-100 antibody staining at the 4th week after operation. The number of Schwann cells in the unit field was calculated by Olympus software and analyzed statistically. Schwann cell proliferation and myelin sheath arrangement were observed under electron microscope 8 weeks after operation. Results: general observation: the mental state and diet of aspirin group were better than that of control group. The paw extension reflex of the aspirin group recovered earlier than that of the control group at 3 ~ 4 weeks postoperatively, and the paw extension reflex in the control group was later than that in the control group, and was improved at the 6th week after operation. At the 4th week after operation, the distal nerve of the nerve anastomosis in the saline group became thinner, the nerve elasticity decreased, and no obvious blood vessels passed through the anastomotic stoma. In the aspirin group, a small amount of blood vessels were seen passing through the nerve anastomotic stoma, and the nerve elasticity was good. There was no significant difference in the diameter of the distal nerve compared with the proximal nerve. The sciatic nerve function index (SFI):) 2 weeks after operation, due to the contracture of the toes of the surgical side of rats, natural prolapse, feet can not be expanded, unable to support the ground, the ischium function index can not be measured. The sciatic nerve index of aspirin repair group was better than that of normal saline group at the 4th week after operation (P0.05). The distance of sensory nerve regeneration in (Pinch test): aspirin group was longer than that in normal saline group, the difference was statistically significant (P0.05). The recovery rate of wet weight ratio of gastrocnemius muscle was significantly higher than that of control group (P0.05), except that there was no statistical difference in the recovery rate of gastrocnemius muscle wet weight ratio at the 2nd week, the aspirin group at the 4th week was better than the control group (P0.05). The diameter of gastrocnemius muscle in aspirin group was higher than that in saline group at 6 and 8 weeks postoperatively (P0.05). Electrophysiological examination: the latency of aspirin group was lower than that of control group, the difference was statistically significant (P0.05), the amplitude of wave in aspirin group was higher than that in control group, the difference was statistically significant (P0.05). The conduction velocity of the experimental group was faster than that of the control group, and the difference was statistically significant (P0.05). Immunohistochemistry: the expression and distribution of S-100 protein in aspirin group was better than that in saline group at the 4th week after operation, and the proliferation of Schwann cells in experimental group was significantly higher than that in control group (P0.05). Electron microscope showed that the thickness of nerve myelin sheath in aspirin group was high, and the shape of nerve myelin sheath was round or ellipse. In aspirin group, the nerve fibers of intact sheath were thickened and arranged neatly, and the myelin sheathing lamina of aspirin group was well distributed. In the control group, the neurofiberboard layer was looser, the myelin sheath was distorted obviously, the thickness was different and the shape was irregular. Conclusion: aspirin can promote the repair of peripheral nerve injury.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R651.3

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