去抗原同种异体静脉套接修复兔面神经损伤

Experiment with a Venous Conduit of Allogeneic and De-antigen Vein to Repair Rabbit Facial Nerve Injury

【目的】以经生物工程处理的静脉导管为支架,应用兔为动物实验对象,观察该方式修复面神经损伤的特点。【方法】54只新西兰大白兔,每只实验兔分别应用静脉导管及自体神经移植吻合修复面神经损伤,手术后行大体观察、生物机能实验系统记录神经动作电位、切片组织学检查。【结果】活体动物手术后观察,静脉导管侧胡须运动、上唇口轮匝肌运动及其运动幅度比自体神经组稍多;生物机能实验系统记录神经动作电位,术后10周和15周时静脉导管侧和自体神经侧均可引出神经动作电位,静脉导管侧的神经传导速度平均值均高于自体神经侧;术后10周,各兔再生神经组织化学染色,静脉导管侧的再生有髓神经纤维分布密集,并见分裂成熟的面神经结构,自体神经侧染色的神经纤维分布稍稀疏,再生的有髓神经结构不完全成熟。【结论】利用生物性天然静脉导管,经生物工程技术处理,克服了天然生物材料引起宿主的免疫排斥反应,比应用自体神经移植更有利于促进神经再生和功能恢复。

[Objective] The repair of the facial nerve injury of rabbits was explored by using the venous conduits. [Methods] The facial nerve injury of fifty-four male New Zealand rabbits were treated by venous conduits and auto nerve grafts. After operations, the macroscopic observations, detections of nerve action potentials and histological evaluations on rabbits were performed. [ Results] Macroscopic findings： The frequency and amplitude of movements of vibrissae and orbicularis otis muscle of the upper lip were improved a little in the sides of venous conduits compared with that in the sides of autografts. Electrophysiological examinations-nerve action potentials could be detected in both sides of venous conduits and autografts at 10 weeks and 15 weeks postoperatively, respectively. The mean velocity of nerve conduction in the sides of venous conduits was greater than that in the sides of autografts. Histologic examinations： at 10 weeks postoperatively, in the sides of venous conduit, regenerated medullated nerve fibers were distributed densely with mature facial nerve structure. While in the sides of autografts, regenerated nerve fibers were distributed sparsely with immature medullated nerve structure. [Conclusion] The natural venous conduit processed by bioengineering technology addresses the immunologic rejection of the host, and offered greater promotion in regard to regeneration and functional recovery of nerves compared with autologous nerve grafts.