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目的 探讨面神经不同损伤程度对面瘫预后的影响。方法 制造豚鼠颞骨内面神经麻痹模型 ,分为压榨面神经 5s组、15s组、30s组 ,再分为观察 1周组、1月组。应用神经电图测试 5s组、15s组、30s组的平均阈值差值。扫描电镜观察各 1周组、1月组口轮匝肌次级突触间隙面积的变化。光镜观察采用琥珀酸脱氢酶和乙酰胆碱酯酶 (AchE)结合酶组织化学染色方法 ,并应用LUZEX F计算机图像分析系统测试各组肌纤维AchE含量的灰度值。通过透射电镜观察各组运动终板结构和AchE阳性反应产物的变化。结果 5s组的平均神经兴奋传导抑制时间为 ( 36 .8± 10 .2 )min ;15s组瞬目反射恢复正常平均需( 4 8.0± 16 .0 )d ;30s组瞬目反射半年内未恢复。扫描电镜观察 5s组次级突触间隙呈正常状态 ;15s 1周组的次级突触间隙面积轻度减少 ,1月组明显恢复 ;30s 1周组的次级突触间隙面积显著减少 ,1月组稍有恢复。 5s 1周组AchE平均灰度值为 5 2 .98± 5 .38,15s 1周组为 6 5 .18± 1.2 1,两组间比较差异有极显著性意义 ( P <0 .0 1) ;30s 1周组为 76 .88± 4.86 ,与 15s 1周组间差异有极显著性意义 ( P <0 .0 1) ;15s 1月组为 5 6 .86± 1.82 ,30s 1月组为 79.45± 2 .2 5 ,两组间比较差异有极显著性意义 (P <0 .0 1)。透射电镜观察 5s
Objective To investigate the effect of different degrees of facial nerve injury on the prognosis of facial paralysis. Methods The model of facial nerve paralysis in guinea pig temporal bone was made and divided into facial nerve 5s group, 15s group and 30s group, then divided into 1 week group and 1 month group. The mean threshold difference of 5s group, 15s group and 30s group was tested by electrogram. Scanning electron microscopy was used to observe the change of the secondary synaptic cleft area of orbicularis oris in each 1 week group. Light microscopy using succinate dehydrogenase and acetylcholinesterase (AchE) combined with enzyme histochemical staining methods, and LUZEX F computer image analysis system to test the gray value of the muscle fiber AchE content of each group. The changes of motor endplate structure and AchE positive reaction products in each group were observed by transmission electron microscope. Results The average nerve conduction time of conduction in 5s group was (36.8 ± 10.2 min). In 15s group, the mean value of blink reflex was normal (4. 8.0 ± 16.0) d. In 30s group, blink reflex did not recover within 6 months . Scanning electron microscopy showed that the secondary synaptic cleft was normal in the 5s group. The area of the secondary synaptic cleft was slightly reduced in the 15s and the recovery in the January group was obvious. The area of the secondary synaptic cleft in the 30s and 1 week groups was significantly reduced. Month group recovered slightly. The average gray value of AchE in 5-week-1 group was 52.98 ± 5.38, and in the 15-week 1-week group was 65.18 ± 1.2 1, with significant difference between the two groups (P <0.01) ; 30s in 1 week group was 76.88 ± 4.86, which was significantly different from 1 week in 15s group (P <0.01); 15 months in January group was 56.86 ± 1.82 and in 30s in January group was 79.45 ± 2.25, there was significant difference between the two groups (P <0.01). Transmission electron microscope observation 5s