嗅鞘细胞移植治疗陈旧性脊髓损伤48例(英文)  

Transplantation of olfactory ensheathing cells for the treatment of obsolete spinal injury in 48 cases

作　　者：郑遵成[1] 刘超[1] 张振兴[2] 王道奎[2] 郑修启[3] 冀永久 郑建森[1] 

机构地区：[1]山东省泰安荣军医院骨科,山东省泰安市271000 [2]潍坊医学院神经外科,山东省潍坊市201041 [3]泰山医学院附属医院神经外科,山东省泰安市271000

出　　处：《中国临床康复》2006年第9期170-172,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:通过改变脊髓损伤局部环境的方法,能够促使损伤的神经修复、再生和恢复脊髓部分神经功能。嗅鞘细胞移植能够改善脊髓损伤的局部内环境。目的:探讨嗅鞘细胞移植治疗对陈旧性脊髓损伤患者脊髓及神经功能修复的作用及安全性。设计:自身对照实验。单位:山东省泰安荣军医院外科病房。对象:纳入山东省荣军医院外科2004-06/2005-07收住院的陈旧性脊髓损伤患者48例。男39例,女9例;年龄7～59岁,平均36岁。方法:①细胞培养:取流产胎儿的嗅球消化成单个嗅鞘细胞,培养纯化1～2周,最后制成单细胞混悬液。②手术及细胞移植:在全麻下进行,将纯化好的嗅鞘细胞的单细胞悬液(约0.05～0.20mL)用自制的直经0.45mm的注射器分多点注射于相应脊髓损伤处,术后10～14d伤口拆线。③脊髓功能评定:术前1d及术后2周～2个月,采用美国脊髓损伤学会制订的脊髓损伤学会评分标准进行评分对比,并进行统计学处理。④术后3周～1年观察或电话随访48例患者脊髓功能情况。主要观察指标:①患者术后感觉功能变化。②患者术后运动功能的变化。③患者术后植物神经功能的变化。结果:①48例患者中均有脊髓功能的改善,且在术后3周～1年的观察或电话随访中仍呈继续改善的趋势。②感觉功能脊髓损伤学会评分术后高于术前(触觉:56.9,51.2,P<0.01;痛觉:55.2,48.3,P<0.01),感觉功能改善以感觉平面下移最明显,一般在两个节段以上。③运动功能脊髓损伤学会评分术后高于术前(44.8,40.7,P<0.01),运动功能改善出现较慢。④植物神经功能脊髓损伤学会评分术后高于术前(18.0,14.5,P<0.01),植物神经功能改善如:出汗、肠蠕动增加出现最早。结论:嗅鞘细胞移植对脊髓损伤晚期患者的脊髓及神经功能的恢复有促进作用,治疗方法安全。BACKGROUND： Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord. OBJECTIVE： To probe into the effect and safety of transplantation of olfactory ensheathing celts on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN： Self-control experiment. SETTING： Wards of the Department of Surgery, Taian Rongiun Hospital of Shandong Province. PARTICIPANTS： Totally 48 patients admitted for obsolcte spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years. METHODS：①Cell culture： Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and purified for 1 to 2 weeks, and finally made into single cell suspension. ②Opelation and cell transplantation： Under general anesthesia, the purified sin- gle cell suspension （about 0.05-0.20 mL） of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 nun in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function： Injury Scoring Standard made by American Spinal Injury Association （ASIA） was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or fol- lowed up through telephone at postoperative 3 weeks to 1 year. MAIN OUTCOME MEASURES： Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients. RESULTS： ①All the 48 patients had improvement in spinal function, and continued imp

关 键 词：脊髓损伤 功能恢复 移植 

分 类 号：R322.81[医药卫生—人体解剖和组织胚胎学]