甲壳胺膜管修复不同长度神经缺损  

The experimental study of repairing peripheral nervedefect with chitin membrane conduit

作　　者：胡勇[1] 董吟林[1] 高学纯[1] 卜海富[1] 尹宗生[1] 

机构地区：[1]安徽医科大学第一附属医院骨科,合肥230022

出　　处：《安徽医科大学学报》2003年第1期37-40,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的　观察甲壳胺膜管桥接大鼠不同长度坐骨神经缺损对神经再生的影响。方法　SD大鼠 1 0 2只 ,随机分为A、B、C 3组 ,按缺损长度与神经干直径之比造模 (A :缺损 4倍 ,B :缺损 6倍 ,C :缺损 8倍 )。用甲壳胺膜管桥接缺损。术后 4、8、1 2周进行大体观察、组织学观察和远端轴突再生率的比较。结果　 4周后各组后肢均形成溃疡 ;8周后A组溃疡愈合 ;1 2周后B组溃疡愈合 ,A、B组无明显肌萎缩 ,能展趾活动 ,有肌肉收缩现象 ;C组溃疡及肌萎缩加重 ;桥接体周围无瘢痕黏连。 1 2周后 ,3组间远端轴突再生率两两比较 :A优于B、C ,B优于C(P <0 .0 1 )。A、B组髓鞘成熟良好 ,C组仍有髓鞘溃变现象 ;3组均无胶原纤维增生。结论　甲壳胺膜管桥接周围神经缺损 ,可防止瘢痕侵入 ,有利于轴突再生。对于神经缺损不超过其直径 6倍者 。Objective To investigate whether the conduit made of chitin membrane can repair the defect of sciatic nerve in rat. Methods 102 rats were divided into 3 random groups A,B,C according to the proportion of the length of defect to the diameter of nerve trunk (A:4 scale,B:6 scale,C:8 scale).The defect was bridged with the conduit of chitin membrane, and general observation, morphologic investigations and comparisons of ratio of distal rege nerated axons were made in 4、8、12 weeks after operation. Results 4 weeks later,all 3 groups came to skin ulcer;8 weeks later,in group A,the ulcer was healed up and the function of limb was restored;12 weeks later,the skin ulce r in group B was healed up and the amyotrophy was alleviated.In group C,the skin ulcer and amyotrophy became heavier.The surroundings of conduit had no ulcer. Morphologic investigations and comparisons of ratio of distal regenerated axons: 12 weeks later,the comparisons of ratio of every 2 groups showed that A was bet ter than B、C( P <0.01) and B was better than C( P <0.01).Conclusion Peripheral nerve defect bridged with chitin membrane conduit can prevent scar from invading and promote axons regenerating. Defect beneath 6 scale bridg ed with the conduit of chitin membrane achieves better effect,while defect upper 6 scale is poorer.

关 键 词：甲壳胺膜管 修复 神经缺损 坐骨神经缺损 神经再生 影响 

分 类 号：R651.3[医药卫生—外科学]