生物套管小间隙套接修复大鼠坐骨神经损伤过程中的疼痛评估  

Pain assessment of biological conduit small gap tubulization in rat sciatic nerve multilation model

作　　者：张培训[1] 安帅[1,2] 王国强[3] 王艳华[1] 陈博[1] 王振威[1] 韩娜[1] 寇玉辉[1] 王韵[3] 姜保国[1] 

机构地区：[1]北京大学人民医院创伤骨科、北京大学交通医学中心,北京100044 [2]首都医科大学宣武医院骨科,北京100005 [3]北京大学基础医学院神经生物学系,北京100191

出　　处：《北京大学学报（医学版）》2013年第5期675-678,共4页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(31171150、31271284、81171146、30971526、30801169、30973066);北京市科技新星计划(2008-A-10);教育部新世纪优秀人才计划(BMU20110270);国家杰出青年科学基金(30625036)资助~~

摘　　要：目的:探讨2 mm小间隙套接缝合和神经外膜缝合修复坐骨神经损伤后疼痛功能恢复的变化。方法:采用SD大鼠制作坐骨神经离断伤模型,断端旋转180°后分别采用2 mm小间隙套接修复和神经外膜缝合修复方式,于术后2、4、5、6、8、12周观察患肢50%缩足阈值,采用成组t检验进行统计学分析。结果:两组动物患肢2周时均出现明显的感觉减退,缩足阈值明显提高,达到15 g。4周时,两组缩足阈值均开始降低,小间隙套接修复组降低明显多于外膜缝合组,说明小间隙套接修复疼痛觉恢复早于外膜缝合组。术后5、6、8、12周,小间隙套接修复组缩足阈值升高至平台期[5周(12.70±5.64)g;6周(12.20±3.26)g;8周(12.31±4.19)g;12周(13.95±2.58)g];外膜缝合组缩足阈值呈下降趋势[5周(10.47±7.02)g;6周(9.42±6.86)g;8周(8.50±7.15)g;12周(8.06±5.93)g]。两组比较12周外膜缝合组缩足阈值显著低于小间隙套接修复组。结论:相比于传统的神经外膜缝合,生物套管2 mm小间隙套接修复大鼠坐骨神经离断性损伤,能够有效地提高周围神经损伤修复过程中的疼痛阈值,减少疼痛的发生。Objective：To explore the pain sensation recovery discipline of 2 mm small gap biological conduit tubulization and epineurial neurorrhaphy in rat sciatic nerve muhilation model. Methods： Based on the rat sciatic nerve multilation model, 2 mm small gap biological conduit tubulization and epineurial neurorrhaphy were applied and the 50% paw withdrawal threshold was observed after 2, 4, 5, 6, 8 and 12 weeks. The data were analyzed by two-way ANOVA and chi-square criterion. Results： Obvious hype- ralgesia was observed in week 2 in both experimental group and control group, and 50% paw withdrawal threshold was improved significantly even to 15 g. The 50% paw withdrawal threshold began to decline week 4 and the 50% paw withdrawal threshold of small gap tubulization group was obviously lower than that of control group, which may imply that the pain sensation recovery of small gap tubulization group was earlier than that of control group. The 50% paw withdrawal threshold of small gap tubulization group began to increase to the plateau period [ week 5： （12.70 ± 5.64） g; week 6：（12.20 ± 3.26） g; week 8：（12.31 ±4.19） g; week 12：（13.95 ±2.58） g]. The 50% paw withdrawal threshold of control group declined gradually [ week 5 ： （ 10.47 ± 7.02） 7.15） g; week 12：（8.06±5.93） g] lization group and control group in 12th g; week6： （9.42±6.86） g; week8： （8.50±7.15）g;week12：（8.06±5.93） g]The difference was statistical significant between small gap tubu- week. Conclusion： Compared with the traditional epineurial neu-rorrhaphy for peripheral nerve multilation, 2 mm small gap biological conduit tubulization can improve the 50% paw withdrawal threshold during peripheral nerve regeneration process and reduce the pain inci- dence.

关 键 词：坐骨神经 神经纤维 缝合技术 生物相容性材料 疼痛 

分 类 号：R641[医药卫生—外科学]