| 毛雅君,励建安,李 冰,刘守国,朱 杰.兔骨骼肌运动点与运动终板的形态学研究及临床意义[J].中国康复医学杂志,2011,26(11):1014~1019 |
| 兔骨骼肌运动点与运动终板的形态学研究及临床意义 点此下载全文 |
| 毛雅君 励建安 李 冰 刘守国 朱 杰 |
| 南京医科大学第一附属医院康复医学科，南京，210029 |
| 基金项目： |
| DOI： |
| 摘要点击次数: 2469 |
| 全文下载次数: 4110 |
| 摘要： |
| 摘要
目的：探索运动点的本质是终末神经纤维密集区，还是运动终板密集区，给化学神经阻断技术的定位方法提供理论依据。
方法：成年新西兰兔9只，靶肌肉为双侧肱二头肌及双侧腘绳肌。每块肌肉选择2个研究点，共计72个点分为3组：小神经密集区（N组）：通过最小电刺激引起最大收缩的部位；运动终板密集区（P组）：肌电图显示终板电活动最活跃的部位；非密集区对照组（C组）：以最强电流诱发最弱靶肌肉收缩，且连接肌电图后未出现终板电活动的部位；在以上部位注入染料定位。分别记录三组的电刺激强度。通过苏木精-伊红染色和乙酰胆碱酯酶染色，应用图文报告分析软件观察运动终板及神经纤维数量，将3组数据进行统计学分析。
结果：电刺激强度比较：C组最大（0.73±0.05）mA，P组次之（0.39±0.04）mA，N组最小（0.10±0.01）mA，3组间两两比较均有显著差异（P<0.01）。神经纤维数量比较：N组最多，P组次之，C组最少。N组与P组之间的差异不显著（P>0.05），但N组与C组，P组与C组之间差异显著（P<0.01）。运动终板数量比较：P组最多，N组次之，C组最少，3组间两两比较差异均有显著性（P<0.05）。
结论：终末神经纤维密集区和运动终板密集区十分接近，但是“运动点”概念不同。临床上可以使用电刺激技术作为肉毒毒素肌肉注射的定位技术。 |
| 关键词：神经阻滞 运动点 运动终板 终末神经纤维 |
| Morphological study and clinical significance of skeletal muscle's motor end plates and motor points in rabbits Download Fulltext |
|
| The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: To characterize the morphology of motor points, i.e. whether they are compact district of nerve fiber or motor end-plate, and therefore to provide rationale for the localization methods during nerve blocking.
Method: Nine New Zealand rabbits were used for the study. The musculus biceps brachii and hamstring bilaterally were selected as target muscles for injection. A total of 72 target points were divided into three groups: compact district of nerve fibers(Group N), where the maximal contraction was induced with minimal electric stimulus; compact district of motor-end plates(Group P), where the end-plate potential was most significant in electromyogram (EMG) monitoring; and a non-compact district control point (Group C), where the weakest contraction of target muscle was induced with maximal electric stimulus, and no end-plate potential was observed in EMG monitoring. All these points were marked by injection of dye during monitoring. The intensities of currents by which the maximal contractions of target muscles were induced were recorded respectively for the three groups, and the amount of motor end-plates and nerve fibers were analyzed and counted with HE (hemotoxylin and eosin) staining and AchE (acetylcholinesterase) staining respectively.
Result: Statistically significant difference （P<0.01）was found by comparison of electric stimulus intensities among these three groups: the current of highest intensity current （0.73±0.05）mA was used in Group C, followed by Group P with the current of average intensity（0.39±0.04）mA, and the the current of lowest intensity(0.10±0.01)mA was used in Group N. Both Group N and P had significantly larger number of nerve fibers than that in Group C （P<0.01）, however, no significant difference between Group N and P （P>0.05） with respect to the amount of nerve fibers. Finally, significantly larger number of motor-end plates was found in Group P than that in Group N and C（P<0.05）.
Conclusion: Distinction characteristics of two types of “motor points” were found in the compact districts of nerve fibers and motor end-plates respectively. However, these two types of “motor points” were geographically associated with each other and therefore the technique of electric stimulus should be employed for the localization during neurolysis with botulinum toxin. |
| Keywords:nerve block motor point motor-end plate terminal nerve fiber |
|
| 查看全文 查看/发表评论 |
|
|
|
|
|
