几丁糖预防周围神经术后粘连的临床疗效观察

Clinical Observation of Chitosan Prevention of Peripheral Nerve Injuries Postoperative Adhesions

目的:为了解决周围神经损伤手术后神经粘连问题,特别是周围神经断伤吻合术后,解决神经纤维的生长与预防粘连问题。方法:在动物实验成功的基础上,临床在周围神经损伤应用显微外科技术行束间松解或外膜—束膜缝合的基础上应用几丁糖局部注入。于手术后6个月至2年观察神经功能恢复情况。结果:共临床应用102例110条神经,按照分级评定神经功能恢复。结果应用几丁糖者周围神经功能恢复和运动神经传导速度及诱发电位波幅明显优于未应用几丁糖者。周围神经粘连术后恢复优良率达91.5%,周围神经断伤吻合术后优良率达84%,总优良率达86.4%。结论:几丁糖具有明确的预防周围神经术后粘连的作用同时能够促进神经纤维的生长;临床应用疗效确切。并可在周围神经损伤的手术中临床推广应用。

Objective：To solve problems of nerve adhesions after surgery on peripheral nerve injury, especially the growth of nerve fibers and the prevention of adhesion after surgery on off peripheral nerve injury. Methods： On the basis of success in animal experiments, to clinically apply Chitosan for partial injection after peripheral nerve injury surgery with micresurgical technique, which releases beams or sutures outer membrane - beam film. To observe the neurological recovery situation six months to two years after the operation. Results： The total clinical application is for 110 nerves out of 102 cases, and functional recovery is assessed in accordance with the classification. Application of Chitosan results in better effect than non - application, in terms of peripheral nerve function recovery, motor nerve conduction velocity and evoked potential amplitude. Peripheral nerve postoperative adhesion recovery excellent rate reached 91.5 percent, off peripheral nerve injury anastomosis recovery excellent rate reached 84 percent, the total rate of excellence reached 86. 4%. Conclusion： Chitosan has a clear prevention effect on postoperative adhesions prevention and at the same time to promote the growth of nerve fibers. The clinical treatment effect is evident and the clinical application of Chitosan can be widely applied in peripheral nerve injury surgery.