不同时段异体神经片段皮下包埋对周围神经再生影响的实验研究  

AN EFFECT OF THE PERIPHERAL NERVE ALLOGRAFT WITH SUBCUTANEOUS PRESERVATION AT DIFFERENT TIMES ON THE NERVE REGENERATION

作　　者：赵波[1] 蒋电明[2] 

机构地区：[1]重庆市第二人民医院骨二科,重庆402160 [2]重庆医科大学附属第一医院骨科

出　　处：《中国修复重建外科杂志》2006年第8期791-796,共6页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨异体神经片段经皮下包埋不同时段后对周围神经再生的影响。方法Wistar大鼠55只,雌雄不限,随机分为5组,A、B、C组(实验组)和D组(对照组)每组各10只,E组(供体组)15只。E组动物在出骨盆口以远5mm处切断双侧坐骨神经,向远端游离约15mm,切断作为移植物。A、B、C组动物均行左侧大腿切口,皮下钝性分离,埋入供体神经片段。术后1周(A组)、2周(B组)、3周(C组)显露右侧坐骨神经,距骨盆出口约5mm处切断,向远端游离约10mm再切断,取出对侧包埋的神经片段,修剪远近端保留长度约10mm,移植于右侧神经缺损处。D组显露右侧坐骨神经后,在距骨盆出口约5mm处切断,向远端游离约10mm后再切断,原位缝合。术后2、4、6、8、10及12周监测坐骨神经功能指数(sciaticfunctionalindex,SFI),术后12周行电生理检查测试运动神经诱发电位的传导速度及潜伏期,组织学检测移植神经再生轴突数目和面积,以及移植神经的超微结构变化。结果术后各组SFI逐渐下降,12周时A组和D组的SFI最小,两组间差异无统计学意义,但分别与B组和C组比较差异有统计学意义(P<0.05)。术后12周A组和D组再生大量有髓神经纤维及少量无髓神经纤维,再生神经的数量和结构与正常神经相似,图像分析显示两组间无明显差别,与B组和C组比较差异有统计学意义(P<0.05)。A组和D组的运动神经传导速度及潜伏期结果无差异,优于B组和C组,且差异有统计学意义(P<0.05)。结论异体神经片断皮下包埋后有促进周围神经再生的作用,皮下包埋1周组促神经再生作用优于皮下包埋2、3周组。Objective To study an effect of the peripheral nerve allograft with subcutaneous preservation at different times on the sciatic nerve regeneration in rats. Methods Fifty-five Wistar rats were used in this experiment, which were randomly divided into the following 5 groups： the experimental groups （Groups A, B, C, 10 rats）, the control group （Group D, 10 rats）, and the donor group （Group E, 15 rats）. In the experimental groups, a 15-ram segment of the sciatic nerve harvested from the donors was separately inserted into the subcutaneous compartment on the left thigh after the 1-week （Group A）, 2-week （Group B）, and 3-week （Group C） preservation; the segment of the sciatic nerve in the subcutaneous compartment was removed and transplanted into a 10-ram defect of the right sciatic nerve, which was made immediately. In Group D, a 10-ram sciatic nerve defect was made and immediately repaired in situ on the right thigh. The function of the sciatic nerve was evaluated by the sciatic functional index （SFI） at 2, 4, 6, 8, 10 and 12 weeks after operation. The histological and electrophysiological examinations were performed at 12 weeks after operation. Results After operation, SFI decreased gradually at 12 weeks after operation, SFI in Groups A and D was at the minimal level and had a significant difference compared with that in Groups B and C （P〈0.05）. There was no significant difference between Group A and Group D. A large number of the myelinated nerve fibers and a small number of the unmyelinated nerve fibers were regenerated in Groups A and D. The number and the structure of the regenerated nerve were similar to the normal ones. The number and the size of the regenerated axon had a significant difference compared with those in Groups B and C （P〈0.05）. There was no significant difference between Group A and Group D. The conduction velocity and the latent period of the motor nerve had significant differences between Groups A and D and Groups B and C （P〈0.05）, and there was

关 键 词：异体神经移植 皮下包埋 周围神经 再生 大鼠 

分 类 号：R651.3[医药卫生—外科学]