化学去细胞同种异体神经移植的临床研究  

Clinical Study on chemically extracted nerve allograft

作　　者：郭义柱[1] 王岩[1] 孙明学[1] 陶笙[1] 唐佩福[1] 梁雨田[1] 卢世璧[1] 

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中华神经外科杂志》2008年第12期916-918,共3页Chinese Journal of Neurosurgery

基　　金：国家自然科学基金（30571875）;北京市自然科学基金重点项目（03G502）

摘　　要：目的评价去细胞同种异体神经移植修复人体周围神经缺损的疗效。方法应用去细胞同种异体神经移植修复21例周围神经损伤缺损的患者，术后定期对患暂进行感觉、运动功能及肌电图检查评估，并进行统计学分析。结果平均随访时间39．2个月，总体优良率为71％。疗效优组8例中最长移植长度为8cm，平均长度为（4．8±2．6）cm，良组7例中最长移植长度为9cm，平均长度为（6．3±2．6）cm，其移植长度大于优组。钝性伤8例中2例恢复优良，锐。肚伤8例中6例恢复优良。结论应用化学去细胞同种异体神经移植修复人体周围神经缺损具有良好的疗效；近端粗大神经疗效较远端神经疗效好。感觉神经恢复良好。移植长度和神经损伤性质（饨性伤，锐性伤）对预后评估可能有影响。Objective To investigate and evaluate the results of our clinical application of chemically extracted nerve allograft to repair peripheral nerve defect. Methods 21 patients with peripheral nerve defect were treated with chemically extracted nerve allografts from April of 2003 to April of 2006, and followed up for the examination of sensation and motion, as well as EMG. The final prognosis was evaluated by four degrees. Results The average follow-up time was 39.2 months. The excellent and good ratio was 71%. The longest length of allograft was 8cm （average length： 4.8 ± 2.6cm） in the excellent group of 8 patients. The longest length of allograft was 9cm （ average length ： 6.3 ± 2.6cm ） in the good group of 7 patients. 6 patients recovered excellently in 8 sharply injured patients, whereas only 2 patients recovered excellently in 8 bluntly injured patients. Conclusions It is clinically feasible to use chemically extracted nerve allograft to bridge the nerve gap. It could avoid the pitfalls of harvesting the nerve autograft. The result was better in proximal peripheral nerve than that in distal one. The length of allograft and the type of injury may influence the prognosis.

关 键 词：周围神经 神经损伤 移植 外科手术 运动 感觉 

分 类 号：R686[医药卫生—骨科学]