周围神经损伤后最佳修复时间时机的选择  

Optimal time for repairing peripheral nerve defects following injury

作　　者：张大鹏[1] 潘世奇[1] 侯明明[1] 杨琪[1] 王延忠 

机构地区：[1]哈尔滨医科大学附属第四医院骨科,黑龙江省哈尔滨市150001 [2]勃利县人民医院骨科,黑龙江省勃利县154500

出　　处：《中国组织工程研究与临床康复》2010年第20期3726-3729,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：黑龙江省卫生厅课题(2007-442)资助~~

摘　　要：背景:关于周围神经损伤的修复机制研究报道较多,但对周围神经损伤修复时间的选择的研究较少。目的:通过观察大白兔周围神经损伤后不同时间修复的效果,以选择周围神经损伤后进行修复的最佳时机。方法:随机将大白兔分为4组。剪下长约1cm的坐骨神经制作周围神经损伤动物模型。即时修复组即时进行神经修复组;2,4周和3个月修复组神经两断端分别固定于肌膜上,缝合伤口,分别在2,4周后和3个月后修复坐骨神经。术后3个月于缝合神经处的取材,检测运动神经传导速度,苏木精-伊红染色行病理学观察,电镜观察移植神经段结构,并进行神经移植体轴突计数。结果与结论:2周修复组大白兔运动神经传导速度明显快于4周和3个月修复组(P<0.01),与即时修复组比较差异无显著性意义(P>0.05)。2周修复组神经移植处组织形态、结构明显好于4周和3个月修复组。2周修复组神经移植体轴突计数明显多于4周修复和3个月修复组(P<0.01)。结果提示在2周后修复神经损伤优于其他时间点,是周围神经损伤后进行修复的最佳时机。BACKGROUND： Most studies regarding peripheral nerve injury repair focus on repair mechanisms rather than selection of repair times. OBJECTIVE： To observe the different time points on peripheral nerve injury repair and to select an optimal time. METHODS： White rabbits were prepared for peripheral nerve injury models and randomly divided into 4 groups. In the immediate restoration group, the injured nerves were repaired immediately. In the other groups, the broken ends were fixed on sarcolemma and the sciatic nerve was repaired at 2, 4 weeks and 3 months after injury. The motor nerve conduction velocity, pathological observation, and structure of transplanted nerve segment were observed at 3 months after operation. The number of axon was also counted. RESULTS AND CONCLUSION： Compared with 4-week and 3-month restoration groups, the motor nerve conduction velocity of the 2-week restoration group was obviously faster （P 0.01）, but the difference was significant compared with the immediate restoration group （P 0.05）. The histomorphology and structure of the 2-week restoration group were better than those of the 4-week and 3-month restoration groups. In addition, the number of axon in the 2-week restoration group was greater than those of the 4-week and 3-month restoration groups （P 0.01）. All results demonstrated that the outcome of 2-week restoration is superior to other time points, which is an optimal time for peripheral nerve injury.

关 键 词：周围神经损伤 不同时间 修复 兔 神经组织工程 

分 类 号：R318[医药卫生—生物医学工程]