甲壳胺膜管修复不同长度神经缺损的实验研究(英文)  

An experimental study of repairing nerve defect in different lengths with chitosan membranous tube

作　　者：胡勇[1] 刘玉玲[2] 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,安徽省合肥市230022 [2]安徽医科大学外科总论实验室,安徽省合肥市230022

出　　处：《中国临床康复》2004年第13期2564-2565,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:目前,将天然可降解生物材料运用于周围神经外科领域,尤其对于神经损伤程度与生物导管适应证之间的关系的研究报道较少。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。探索此方法在不同程度神经损伤修复中的适应证。设计:完全随机对照实验研究。地点和对象:安徽医科大学实验外科中心。实验对象为清洁级SD大鼠,体质量220～240g,雌雄不限,由安徽医科大学实验动物中心提供。干预:SD大鼠102只,按缺损长度与神经干直径之比造模分为缺损4,6,8倍组。采用相互对照,用甲壳胺膜管桥接缺损,层流室饲养4,8,12周后处死动物。主要观察指标:术后4,8,12周分别作大体观察、超微结构的透射电镜观察、组织学观察和远端轴突再生率的比较。结果:缺损4,6倍组,能展趾活动,有肌肉收缩现象。缺损8倍组溃疡及肌萎缩加重。桥接体周围无疤痕粘连。缺损4倍组优于缺损6,8倍组,缺损6倍组优于缺损8倍组,缺损4,6倍组髓鞘成熟良好,缺损8倍组仍有髓鞘溃变现象;3组均无胶原纤维增生。结论:甲壳胺膜桥接周围神经缺损,可防止疤痕侵入,有利于轴突再生。对于神经缺损不超过其直径6倍者,用甲壳胺膜管桥接后再生轴突的质量和数量均较优。BACKGROUND:Recently,the reports about the application of natural degradable bi omaterial in peripheral nerve surgery field,especially the relationship between the severity of nerve injury and the indication of biological ductus,were rare. OBJECTIVE:To observe the impact of bridging the sciatic nerve defect in differ ent lengths with chitosan membranous tube on nerve regeneration in the rat and t o explore the indication of this method in the repair of nerve injury with diffe rent severity. DESIGN:A completely randomized controlled study. SETTING and MATERIALS:The study was completed in the Experimental Surgery Cent er of Anhui Medical University.Subjects were SD rats(grade cleanness) in either gender with a body weight from 220 g to 240 g obtained from Experimental Animal Center of Anhui Medical University. INTERVENTIONS:Totally 102 SD rats were allocated into four-time defect(4-fol d defect),six-time defect(6-fold defect) and eight-time defect(8-fold defect ) groups according to the ratio of the length of defect to the diameter of nerve stem.Inter-control was introduced.Defects were bridged by chitosan membranous tube.Animals were fed in laminar flow room and executed at 4,8 and 12 weeks. MAIN OUTCOME MEASURES:General observations, ultrastructure observations under transmission electron microscope,histology observations and the comparison in th e regeneration rates of axons at distal end were assayed respectively at 4,8 and 12 weeks after the surgery. RESULTS:4-fold and 6-fold defect groups had toe spread-out and muscle contr action.There was no scar adhesion around bridging.The result of 4-fold-defect group was better than that of 6-fold defect and 8-fold defect groups.6-fold d efect group was better than that of 8-fold defect group.The maturities of myeli n sheath in 4-fold and 6-fold defect groups were good,while there was still ul ceration in myelin sheath in 8-fold defect group.There were no collagen hyperpl asias in all 3 groups. CONCLUSION:Peripheral nerve defect bridged by chitosan membran

关 键 词：甲壳胺膜管 修复 周围神经缺损 实验 周围神经外科 周围神经再生 

分 类 号：R651.3[医药卫生—外科学]