聚乳酸与聚羟基乙酸共聚物三维神经导管内微丝直径对周围神经缺损修复的影响  

The optimal diameter of microfilaments in polylactic polyglycolic polymer three-dimensional conduit in repairing peripheral nerve defects

作　　者：钟荣国[1] 李志跃[1] 李际才[2] 

机构地区：[1]中南大学湘雅三医院骨科,长沙410013 [2]湖南省石门县人民医院骨科

出　　处：《中华实验外科杂志》2010年第1期108-110,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 应用含有微丝的聚乳酸与聚羟基乙酸共聚物（PLGA）三维神经导管修复大鼠周围神经缺损,最终探寻修复周围神经微丝直径的最佳范围.方法 将60只300～350 g健康、雌雄不拘SD大鼠随机均分为6组.制作大鼠12 mm的左侧坐骨神经缺损模型;A、B、C、D、E组PLGA神经导管内纵形放入20根不同直径（分别是60、80、100、120、140μm）微丝,各组神经导管内均注入层黏蛋白＋神经生长因子混合液0.3 ml.F组：自体神经移植组.大鼠左后肢为实验侧,右后肢为对照侧.测量术后12周各实验组神经导管内再生神经的运动神经传导速度,通过免疫组织化学检测再生神经纤维的数目.结果 术后12周,再生神经中1/3段的光镜观察,各组再生神经均有通过神经导管长入远端,神经纤维计数以F组最多,B、C、D组次之,而与A组、E组比较差异均有统计学意义（P〈0.05）,B组、C组、D组、F组的再生神经纤维数量及成熟程度均要明显优于A组和E组.结论 三维立体管状结构中的微丝直径粗细对周围神经的再生有影响,最佳的直径80～120μm.Objective To studythe optimal diameter of microfilaments in polylactic polyglycolic polymer（PLGA）three-dimensional nerve conduit in repairing peripheral nerve defects of rats.Methods Sixty adult SD rats（weighing 300-350 g）were randomly divided into 6 groups（n=10）,and their sciatic nerves（length：12 mm）were resected.In all groups except F group nerve defects were repaired using the PLGA nerve conduit containing 20 microfilaments with different diameters（60,80,100,120,and 140μm）.The nerve conduits of all groups were filled with 0.3 ml laminin and never growth factor.The rats in group F were subjected to nerve autograft（control group）.The left-behind legs served as experiment sides,and the right ones as control sides.To evaluate the repairing outcome,special assessments were performed including EMG testing,immunohistochemisty to test the number of regeneration nerves 12 weeks after operation.Results Twelve weeks after operation,compared to groups A and E,the conducting velocity and the weight of triceps muscle of calf were increased in groups B,C,D and F（P〈0.05）.However,there was no significant difference in atrophy oftriceps muscle among groups B,C,D and F（P〉0.05）.Under light microscope and electron microscope,it waft,found there was significant difference in nerve fiber diameter,thickness of myelin sheath,and fiber density between groups B,C or D and groups A or C（P〈0.05）.Furthermore,image analysis suggested in the groups F,C,B,and D the nerve regeneration was better than in groups A and E in quantity of nerve fiber,thickness of myelin sheath,and nerve fiber diameter（P〈0.05）.Conclusion The diameters of microfilaments in three-dimensional nerve conduit can influence the regeneration of sciatic nerves,and the optimal diameter range is 80-120μm.

关 键 词：周围神经 神经导管 组织工程 

分 类 号：R651.3[医药卫生—外科学]