摘要
目的：观察三叉神经痛的患支有无病理改变，加深对三叉神经痛发病机制的认识。方法：三叉神经痛患者６例，术中将患支切取一小块，２％戊二醛固定，１％锇酸后固定，环氧树脂包埋，醋酸双氧铀和枸橼酸铅双重染色，超薄切片，电镜下观察。结果：６例患支均有病理改变，但并非所有神经纤维都有病变。主要病理改变有：雪旺细胞浆内有脂滴沉积、髓鞘碎片及空泡样变性；髓鞘增生结构紊乱，髓鞘层板松解、局灶性脱髓鞘等。结论：三叉神经痛确有其病理学基础，主要为雪旺细胞和髓鞘的病变；周围支切除术应尽量在高位进行，以尽可能多地切除病变神经组织。
Objective: To further investigate whether there are pathologic changes in the affected branches of trigeminal neuralgia, and get a deeper understanding about its pathogenetic mechanism. Methods: Specimens of the affected branches from 6 patients suffering from trigeminal neuralgia were obtained during operation, fixed in 2% glutaraldehyde and postfixed in 1% osmium tetroxide. The material was dehydrated through graded alchols, and then embedded in Spurr resin. Ultrathin sections were stained with both lead citrate and uranyl acetate. The sections were examined under an electron microscope. Results: In all specimens, many fibers appeared to be pathologic changes whereas others were normal. The main finding in the affected branches was the pronounced involvement of the myelin sheath and Schwann cell. Lipid deposit, vacuoles, and myelin sheath fragments were seen in the Schwann cell cytoplasm. The myelin sheath presented the proliferation and disorganization, looseningup of the lamellae, and focal demyelination. Conclusion: There are indeed pathologic changes in the affected branches of trigeminal neuralgia, which involves the Schwann cell and myelin sheath degeneration. Rhizotomy of the trigeminal nerve should be performed in the higher level so as to remove more degenerative nervous tissue and reduce recurrence rate.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1998年第4期370-372,共3页
Academic Journal of Second Military Medical University
关键词
三叉神经痛
病理
电子显微镜
trigeminal neuralgia
pathology
microscopy, electron
