自体神经组织匀浆修复面神经缺损的实验研究  

The experimental study of facial nerve regeneration through E-PTFE tube with nervous homogenates

作　　者：徐欣[1] 魏魁杰[1] 马跃[1] 黄海云[1] 王继同[1] 

机构地区：[1]山东大学口腔医学院,山东济南250012

出　　处：《上海口腔医学》2004年第6期523-527,共5页Shanghai Journal of Stomatology

基　　金：山东省自然科学基金(Q99c14)

摘　　要：目的:观察聚四氟乙烯膜管内植入自体神经组织匀浆桥接兔面神经缺损的修复效果,寻找修复面神经的新方法。方法:36只成年新西兰大白兔,均制成双侧面神经颊支8mm缺损的模型,用聚四氟乙烯膜管内植入自体神经组织匀浆桥接每只动物右侧面神经缺损作为实验组,单纯膜管桥接左侧为对照组。分别于术后4、8、12周行神经电生理测试后,处死动物,切取再生的神经组织标本进行大体观察、HE染色,普通光镜观察。结果:电生理测试显示,匀浆组术后4周,电刺激通过神经缺损区可引起肌收缩,空管组未引出肌动作电位。术后8、12周两侧均有动作电位引出,但匀浆组的神经传导速度明显大于空管组。光镜观察,匀浆组在术后各个时期神经再生情况均优于对照组,术后8周匀浆组管内充满再生神经纤维和髓鞘,排列较规则、整齐,呈束状分布,束间新生血管丰富;空管组有极少量再生神经纤维通过缺损区,纤维排列较紊乱。结论:自体神经组织匀浆进行神经再生室内移植,可获得比空膜管桥接面神经缺损更好的修复效果。PURPOSE: To investigate the effect of using e-PTFE containing nervous homogenates to repair the rabbit facial nerve defect. METHODS: Thirty-six adult New-Zealand rabbits weighing 2000-2500g were randomly selected. The right sides were selected as e-PTFE containing nervous homogenates group, 8mm defect of facial never were made, then the defect was bridged with e-PTFE tube, and the nervous homogenates were implanted into the e-PTFE tube. The left sides were selected as e-PTFE group,8mm defect of facial never were made, the proximal and distal stumps were simply bridged with e-PTFE tube. Regeneration of the nerve was assessed by gross observation, nerve electrophysiological test and optical microscope observation. RESULTS: The electrophysiological examination showed that in the e-PTFE group, there was no muscular contraction; while in the homogenates group, the electric stimulus could get through the nerve defect at 4th week. The nerve conduction velocity of the homogenates group recovered better than that of the e-PTFE group at 8th, 12th week. Optical microscope observation showed that at 4th week, in the e-PTFE group, the proximal and distal nerve stumps denervated widely;while in the homogenates group, all the proximal nerve stumps regenerated through the chamber and reached the distal end.At 8th week,in the e-PTFE group, the regenerating nerve fiber got through the nerve defect, the nerve fibers were sparse and arranged in disorder throughout the tube.In the homogenates group, the tube was filled with regenerating nerve fibers which arranged in order.At 12th week, in the e-PTFE group, the nerve fibers lined up in orders, but there existed the phenomena that the nerve fibers were confused. In the homogenates group, regenerating nerve fibers were mature. CONCLUSIONS: From this experiment, we found that the effect of e-PTFE containing nervous homogenates to repair the facial never was better than that of e-PTFE group.

关 键 词：神经再生 面神经 膨体聚四氟乙烯 自体神经组织匀浆 兔 

分 类 号：R651.3[医药卫生—外科学]