聚-DL-乳酸可吸收医用膜防止周围神经粘连的实验研究

The experimental study of poly-DL-lactic acid absorbable membrane in prevention of peripheral nerve adhesion

目的研究聚-DL-乳酸(PDLLA)可吸收医用膜防止周围神经损伤修复后粘连形成的作用。方法SD大鼠60只,随机分成两组,即单纯缝合+PDDLA组(实验组)和单纯缝合组(对照组),每组各30只。坐骨神经切断后显微缝合,实验组缝合口局部用PDLLA膜包裹,对照组未做处理。术后2、4、8、12、16周行大体观察和组织学检查,术后12、16周行神经电生理检查,术后16周行计算机图像分析。结果实验组神经缝合口局部瘢痕增生和粘连程度较对照组明显减轻,再生神经纤维较直,排列结构较整齐。电生理检查和计算机图像分析结果显示实验组的效果明显优于对照组。结论PDLLA可吸收医用膜能有效地防止周围神经修复后局部瘢痕组织增生和粘连的形成,提高神经功能恢复的效果。

Objective To study the effect of poly-DL-lactic acid （PDLLA） absorbable membrane on preventing adhesion after repair of peripheral nerve injury. Methods 60 SD rats were divided into 2 groups randomly： the suturing ＋ PDLLA group （experimental group） and the purely suturing group （contrast group）, with 30 rats in each group. Their sciatic nerves were cut off and then sutured microsurgically. In the experimental group, the anastomotic stoma was encapsulated with PDLLA membrane; in the contrast group, there was no such a treatment. We conducted gross observations and histological examinations at 2, 4, 8, 12, and 16 weeks after operation, neural electrophysiological examinations at 12 and 16 weeks after operation, and image analysis by computer at 16 weeks after operation. Results The scar proliferation and adhesion near the anastomotic stoma in the experimental group were less extensive than those in the contrast group; regenerative nerve fibers grew more straight and orderly manner. Electrophysiological examinations and image analyses by computer also showed that the experimental group achieved better results than the contrast group. Conclusion Poly-DL-lactic acid （PDLLA） absorbable membrane can prevent scar proliferation and adhesion after repair of peripheral nerve and promote nerve functional recovery effectively.