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目的 :探讨喉返神经在迷走神经颈段的位置及应用神经端侧吻合术修复喉返神经损伤的效果。方法 :SD大鼠 2 0只 ,采用剥离法 ( 10只 )及乙酰胆碱酯酶组织化学染色法 ( 10只 )确定喉返神经在迷走神经中的位置 ;将 60只SD大鼠分为 3组 :实验组 :切断右侧喉返神经 ,将其远断段与迷走神经颈段喉返束端侧吻合 ;对照组 :切断右侧喉返神经后立即行神经端端吻合。正常组不做处理。术后 1、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 :喉返束位于迷走神经前内侧 ,单独成束 ,直径为总干的 1/ 4。术后 1个月实验组与对照组纤维喉镜及神经肌电图检查结果差异有显著性意义 ( P <0 .0 5 )。术后 3个月两组检查结果差异无显著性意义 (P >0 .0 5 )。结论 :喉返神经在迷走神经中的准确定位 ,为手术操作提供了重要的解剖标志 ;神经端侧吻合术效果与神经端端吻合术相似 ,为喉返神经修复术提供了一种新的手术方法
Objective: To investigate the location of the recurrent laryngeal nerve in the cervical segment of the vagus nerve and the effect of repairing the recurrent laryngeal nerve injury by applying the nerve end-to-side anastomosis. Methods: Twenty SD rats were divided into three groups according to the method of stripping method (10 pieces) and acetylcholinesterase (10 pieces). 60 SD rats were divided into 3 groups: experimental Group: The right recurrent laryngeal nerve was cut off, and its distal segment was anastomosed with the laryngeal fasciculus end of cervical vagus nerve. The control group: the right recurrent laryngeal nerve was severed immediately after cutting the right recurrent laryngeal nerve. Normal group does not deal with. The vocal cord activity and nerve regeneration were observed with fiber laryngoscope and electromyography at 1 and 3 months after operation. Results: The laryngeal return beam was located in the medial front of the vagus nerve and was bundled separately. The diameter was 1/4 of the total dry diameter. One month after operation, there was a significant difference between the experimental group and the control group in terms of fiber laryngoscopy and neuromyo-electromyography (P <0.05). There was no significant difference between the two groups in postoperative 3 months (P> 0.05). CONCLUSIONS: Accurate localization of the recurrent laryngeal nerve in the vagus nerve provides an important anatomic landmark for surgical procedures. The effect of an anastomosis of the nerve end-to-side anastomosis is similar to that of the nerve end-to-anastomosis and provides a new surgical method for recurrent laryngeal nerve repair