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目的 研究神经再生室中周围神经修复过程各组成成份的变化过程。方法 将大鼠坐骨神经于股中部切断后分隔 5mm ,用硅胶管套接。术后 7、14、2 1、2 8、3 5、42d在透射电镜下观察神经再生室(长 5mm ,分 5个节段 ,每节段长约 1mm)中各节段细胞的超微结构。结果 术后 7d神经再生室中主要为单核细胞、红细胞、纤维蛋白 ;于 1mm和 5mm处还可见到含髓样变性小体的巨噬细胞和新生的成纤维细胞 ;特别是在 1mm处可见雪旺细胞包裹的无髓神经纤维。术后 14d有髓、无髓神经纤维已贯穿全室 ,神经再生室中段已有较多的含丰富内质网的新生成纤维细胞和新生毛细血管。术后 2 1、2 8、3 5、42d神经再生室中各段组织皆为不同成熟程度的有髓和无髓神经纤维 ,并被成纤维细胞突起包裹成小束 ,束间有不少胶原纤维。结论 术后 7d神经再生室近端已见再生轴突 ,术后 14d再生的神经已贯穿全管。神经再生室中成份的变化提示 ,神经再生需要有利的微环境。
Objective To study the changes of the components of the peripheral nerve in the nerve regeneration room. Methods The rat sciatic nerve was cut off in the middle of the femoral nerve and separated by 5mm. At 7, 14, 2, 12, 8, 35 and 42 days postoperatively, the ultrastructures of the cells in each segment in the nerve regeneration room (5 mm in length, 5 segments, 1 mm in length) were observed under transmission electron microscope . Results The main nerve regeneration chamber was mononuclear cells, erythrocytes and fibrin 7 days after operation. Macrophages and myofibroblasts containing myeloid degeneration were also found at 1mm and 5mm, especially at 1mm Schwann cell-wrapped unmyelinated fibers. Fourteen days after surgery, myelinated and unmyelinated nerve fibers have been found in the whole room. There are more newborn fibroblasts and newborn capillaries with abundant endoplasmic reticulum in the middle of the nerve regeneration room. At 2, 12, 8, 35, and 42 days after operation, all the tissues in the nerve regeneration room were all myelinated and non-myelinated nerve fibers with different degrees of maturity, and were surrounded by fibroblasts into small bundles with many collagen fiber. Conclusions 7 days after operation, regenerative axons have been seen in the proximal part of the nerve regeneration room. The nerves regenerated on the 14th day after operation have penetrated the whole duct. Changes in the components of the nerve regeneration chamber suggest that nerve regeneration requires a favorable microenvironment.