周围神经缺损修复新方法--神经延长术  

New treatment for peripheral nerve defects: nerve elongation

作　　者：寇玉辉[1] 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

出　　处：《北京大学学报（医学版）》2016年第5期753-755,共3页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(31571236;81372044);北京大学人民医院研究与发展基金(RDB2015-11)资助~~

摘　　要：周围神经缺损在临床上常见,也是临床治疗的难点[1]。创伤性神经缺失、神经肿瘤医源性切除、神经延期修复时的神经短缩等均可导致不同程度的神经缺损[2-5],我国每年周围神经缺损患者高达30～50万例。对于小的周围神经缺损,Peripheral nerve defects are still a major challenge in clinical practice,and the most commonly used method of treatment for peripheral nerve defects is nerve transplantation,which has certain limitations and shortcomings,so new repair methods and techniques are needed. The peripheral nerve is elongated in limb lengthening surgery without injury,from which we got inspirations and proposed a new method to repair peripheral nerve defects： peripheral nerve elongation. The peripheral nerve could be elongated by a certain percent,but the physiological change and the maximum elongation range were still unknown. This study discussed the endurance,the physiological and pathological change of peripheral nerve elongation in detail,and got a lot of useful data. First,we developed peripheral nerve extender which could match the slow and even extension of peripheral nerve. Then,our animal experiment result confirmed that the peripheral nerve had better endurance for chronic elongation than that of acute elongation and cleared the extensibility of peripheral nerve and the range of repair for peripheral nerve defects.Our result also revealed the histological basis and changed the rule for pathological physiology of peripheral nerve elongation： the most important structure foundation of peripheral nerve elongation was Fontana band,which was the coiling of nerve fibers under the epineurium,so peripheral nerve could be stretched for 8. 5%- 10. 0% without injury because of the Fontana band. We confirmed that peripheral nerve extending technology could have the same repair effect as traditional nerve transplantation through animal experiments. Finally,we compared the clinical outcomes between nerve elongation and performance of the conventional method in the repair of short-distance transection injuries in human elbows,and the post-operative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group. On the whole,all of these experimental resul

关 键 词：周围神经 神经延长 神经缺损 修复 

分 类 号：R651.3[医药卫生—外科学]