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目的:探讨劈开颈段迷走神经中喉返神经支修复大鼠声带麻痹的手术方法和手术效果。方法:首先运用剥离法及乙酰胆碱酯酶组织化学染色方法确定喉返神经支在颈部迷走神经中的位置,将60只SD大鼠被分为3组,实验组为迷走神经劈开术吻合组,切断右侧喉返神经,将其远断段与劈开的颈段迷走神经的喉返支吻合。对照组为喉返神经端端吻合组,切断右侧喉返神经后立即行神经吻合。正常组不做处理。术后3个月利用纤维喉镜及神经肌电图观察声带活动及神经再生情况。结果:喉返神经束位于颈段迷走神经前内侧,单独成束,直径为总干的1/4。术后3个月2种手术方法效果差异无统计学意义(P>0.05)。结论:对喉返神经在迷走神经中准确定位,为手术操作提供了重要的解剖标志。迷走神经劈开术为喉返神经修复术提供一种新的手术方法。
Objective: To investigate the operative methods and operative results of vocal cord paralysis in cleaved cervical vagal nerve with recurrent laryngeal nerve branches. Methods: Sixty Sprague-Dawley rats were divided into three groups by peelation method and acetylcholinesterase histochemical staining method. The experimental group was anastomosis vagus nerve cleavage group, The right recurrent laryngeal nerve, its distal segment and split cervical vagal nerve throat back anastomosis. The control group was the anastomosis group of recurrent laryngeal nerve, and the nerve anastomosis was performed immediately after cutting off the right recurrent laryngeal nerve. Normal group does not deal with. Three months after operation, the changes of vocal cord activity and nerve regeneration were observed by using fiber laryngoscope and electromyography. Results: The recurrent laryngeal nerve bundle was located in the medial anterior vagal nerve of the cervical spine. It was bundled separately and its diameter was 1/4 of the total dry. There was no significant difference between the two methods in 3 months after surgery (P> 0.05). Conclusion: Accurately positioning the recurrent laryngeal nerve in the vagus nerve provides an important anatomical landmark for surgical procedures. Vagus nerve splitting provides a new surgical method for recurrent laryngeal nerve repair.