臺灣博碩士論文加值系統

股動靜脈是下肢血液的流動通道，由自主神經控制其血管直徑。已知自主神經末梢以網狀圍繞在股動靜脈血管外膜，但此血管的傳入和傳出路徑細節尚不清楚；故本實驗利用大片組織製備法(whole mount)與神經追蹤劑西洋山奏皝L氧化酶(WGA-HRP)注射或包埋(HRP)，搭配單側交感神經截斷術(sympathectomy)，來釐清股動靜脈血管壁的明確解剖連接路徑。注射WGA-HRP到交感神經幹(sympathetic trunk) 的L2~L3 位置，經染色反應後，可看到傳出神經從L5的位置離開，然後分成兩個神經束分支，分別沿著血管往主動脈及下腔靜脈方向連接，但無法染到神經末梢細節。第二個實驗使用HRP溶液(20%)包埋左右兩側的股動脈或股靜脈，並在神經分岔處(即L5的位置)進行單側交感神經截斷術，目的在驗證傳出和傳入神經是否在喙端處由上述新標定的神經束為其進出路徑並同時探索其神經細胞本體的分佈情形。結果發現傳出和傳入神經的確經過新標定的神經路徑進出股動靜脈且兩者並非經由文獻所指的股神經出入。股動靜脈交感傳出神經的細胞本體分佈在交感神經結的L1~L3，而以L2、L3居多；感覺神經元則分佈在背根神經節的L4~L6位置，其中動脈以L5為主，靜脈以L4居多。此結果顯示，股動靜脈有自己專屬直接的傳入和自主神經傳出路徑，而非如通往下肢皮膚、肌肉等自主神經需透過體神經的間接路徑。

The autonomic nervous system controls the diameter of the femoral vessels which supply the blood flow of the low extremities. The detailed gross anatomical pathway that projects to the femoral vessels has not been well established. In the present study, we adopted the techniques of whole mount tissue preparation and the track-tracing neural tracer (WGA-HRP and HRP) combined with the sympathectomy to anatomically reveal the neural connection of the femoral vessels. After injecting the WGA-HRP into the sympathetic trunk at the L2~ L3 level, the nerve was divided into two nerve bundles at L5 level and respectively travel caudally along the blood vessels toward the abdominal aorta and the inferior vena cava; however, the nerve endings could not be traced. In the second experiment, the adventitia of the femoral artery or vein on both sides were separated and soaked with HRP solution (20%) combined with a sympathectomy caudal to the L5 level to verify whether the newly identified nerve bundles are the pathways for the afferents and sympathetic efferents and to explore the distribution of their somata. The data have shown that the afferents and sympathetic efferents do travel through the newly identified pathways connecting to the femoral vessels and not through the femoral nerve as suggested in the literature. The sympathetic postganglionic neurons that innervate the femoral vessels are distributed from L1 to L3 and mainly in the L2 and L3; while the afferent neurons are located from L4 to L6 and the femoral artery are mainly in L5 and the vein are in L4. These data indicate that the femoral vessels have their own direct innervation pathways which are not via the somatic path as the indirect innervation of the skin and muscles in the low extremity.

LIST OF FIGURES AND TABLES ……………….iii
ACKNOWLEDGMENT ……………………………v
摘要 …………………………………………………vi
ABSTRACT ………………………………………vii
INTRODUCTION …………………………………1
MATERLALS AND METHODS……………………5
Subjects………………………………………………5
Tracer and Surgery …………………………………5
Perfusion and Histology………………………………7
Cell Count and Statistical Analysis……………………9
RESULTS ……………………………………………11
Femoral Artery Tracing………………………………16
Femoral Vein Tracing…………………………………16
DISCUSSION…………………………………………23
REFERENCES ………………………………………27

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