超深低温处理的同种异体神经移植的临床研究  

Clinical study of nerve allografts by deep hypothermia.

作　　者：唐林俊 陈浩贤 崔太安 杨志贤[2] 

机构地区：[1]成都现代医院,四川成都610041 [2]解放军第401医院,山东青岛266071

出　　处：《四川医学》2010年第10期1516-1517,共2页Sichuan Medical Journal

摘　　要：目的建立一种既能显著降低神经免疫源性又能长期储存的新的组织库技术,并初步临床应用。方法由10%二甲基亚砜及纯小牛血清组成的冷冻保护剂,无菌取新鲜人体指神经放入液氮中长期储存。移植前,液氮中取出立即将冷冻管放入40℃水浴中快速复温,含10%胎牛血清的RPMI1640液洗涤复苏神经,使二甲基亚砜缓慢释放后供临床异体移植用。复苏神经用酶消化法获取细胞成分,并用0.4%台盼蓝染色确定细胞活力,同时做组织学检查。临床应用2例,6条神经,其中1例4条,平均长3.25cm。结果超深低温处理的神经细胞大部成活,光镜及电镜示神经水肿变性不明显。临床移植均随访12个月,静止两点辨别觉为6～10mm,均无异常感觉,患者十分满意。结论超深低温处理的指神经是活体神经,异体移植临床应用效果好,此种处理的神经可优先用于纯感觉神经的修复。Objective To establish a significant tissue-bank technology not only reducing the nerve immunogenicity also storaging long-termly,and apply preliminarily in clinic.Methods The fresh donor finger nerve was preserved in the cryopreserved solution which included 10% dimethyl sulfoxide（DMSO） and fetal calf serum,and for long-term storage into the liquid nitrogen.Before transplantation,it was taken out and immediately washed at 40℃ temperature water to rapid recovery and slowly release DMSO for clinical allogeneic transplant.Recovery nerve cells were obtained by enzymatic digestion and stained by 0.4% Typan blue to determine cell viability,and histology.Two patients with six nerves were transplanted with an average length of 3.25cm.Results The nerve cells by deep cold frozen mostly were survival.The degeneration and edema of nerve was not obvious in light microscopy and electron microscopy.They were followed up for 12 months.Still two-point discrimination was 6～10mm.Abnormal feeling was discovered.Patient satisfaction was obtained.Conclusion Finger donor nerve by deep hypothermia is living nerve.Good clinical effect was obtained by allograft nerve.Sensory nerve repairing could be priory such this technology.

关 键 词：同种异体 神经 超深低温 移植 冷冻 

分 类 号：R651.3[医药卫生—外科学]