神经延长术修复周围神经缺损实验研究  

Repairing peripheral nerve defects with gradual lengthening of nerve stumps

作　　者：莎茹拉[1] 沈俊[1] 张长青[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《国际骨科学杂志》2017年第2期110-114,共5页International Journal of Orthopaedics

基　　金：国家自然科学基金青年科学基金(81201387)

摘　　要：目的探讨神经延长术修复周围神经缺损疗效。方法切除实验组家兔右侧大腿中段坐骨神经20 mm以建立神经缺损模型,用自制神经延长器逐渐延长坐骨神经断端,3周后行神经端-端缝合术。在对照组家兔右侧相同位置切除坐骨神经20 mm以建立神经缺损模型,将切取的神经180°翻转后进行回植,采用8-0丝线进行神经端-端缝合术。初次手术后16周,两组均进行运动神经传导速度、腓肠肌湿质量及再生有髓神经纤维数目、有髓神经纤维直径、神经纤维面积比例检测。结果实验组运动神经传导速度、腓肠肌湿质量及再生有髓神经纤维数目、有髓神经纤维直径、神经纤维面积比例均优于对照组。结论神经延长术可作为修复周围神经缺损的新方法,其有望取代自体神经移植术。Objective To investigate the efficacy of a new technique to repair peripheral nerve defects with gradual lengthening of the nerve stumps.Methods A20-mm-long nerve segment was resected from the rabbit sciatic nerve.Both nerve stumps were lengthened gradually by a customized nerve lengthening device.After 3 weeks,a direct end-to-end neurorrhaphy was performed.As a control,a20-mm-long segment of sciatic nerve was removed in the right side,then reversed at 180°,and reimplanted between the nerve stumps using 8-0sutures.At16 weeks after the first operation,nerve regeneration was evaluated by motor nerve conduction velocity,muscle wet weight,total number of myelinated fibers,mean axonal diameter and percent neural tissue in both groups.Results The nerve lengthening group achieved significantly better results than the autografting group in terms of motor nerve conduction velocity,muscle wet weight,total number of myelinated fibers,mean axonal diameter and percent neural tissue.Conclusion The gradual nerve lengthening procedure can be used as an alternative to repair peripheral nerve defects.

关 键 词：坐骨神经 周围神经缺损 神经延长 神经修复 

分 类 号：R651.3[医药卫生—外科学]