联合运用冻融法和化学法去细胞同种异体神经修复兔面神经缺损

Repair of facial nerve defect with freeze-thaw and chemical acellular allogenic nerve in rabbits

目的:通过对去细胞同种异体神经处理方法的改进,找出一种修复兔面神经缺损的理想替代材料。方法:取24只兔子,将兔左侧面神经上颊支切断以造成面神经缺损1.0cm的模型,根据修复方法不同,随机分成2组:实验组为联合运用冻融法和化学法去细胞同种异体神经修复组,对照组为自体面神倒置修复组,每组12只。术后3个月行大体观察、神经电生理检测、有髓神经纤维计数以及电镜观察,采用SPSS17.0软件包对数据进行t检验,对面神经恢复情况进行综合评价。结果:两组兔子均存活,切口愈合良好,兔面形基本对称;实验组与对照组左侧面神经上颊支传导速度分别为(55.74±10.56)m/s及(61.34±9.72)m/s,差异无显著性(P>0.05);实验组与对照组移植体远端吻合口邻近4.0mm段有髓神经纤维数量分别为(18173.62±918.38)n/mm2及(18601.21±982.31)n/mm2,差异亦无显著性(P>0.05);电镜检查结果相似。结论:联合运用冻融法和化学法去细胞同种异体神经能满意修复一定长度的面神经缺损,可以作为自体神经的一种有效替代物。

Objective Through improve the preparative method of extracted acelluar nerve allograft,explore an new effective alternative material for the repair of facial nerve defect.Methods Took 24 rabbits and a 1.0 cm facial nerve gap was made on the left buccal branch of the rabbits.According to different repair methods,the twenty-four rabbits were randomly divided into trial group that repaired facial nerve defect with freeze-thaw and chemical acellular allogenic nerve graft and control group that repaired facial nerve defect with inverted autologous facial nerve.Each group had 12 rabbits.Some examinations of the two groups were done on the 3th month postoperative,including visual observation,neural electrophysiological testing,image analysis of myelinated nerve fibers as well as electron microscope observation.Using t tests to comprehensive evaluation the data of the recovery of facial nerve with SPSS17.0 software package.Results Two groups of rabbits were alive,the incision healed well and the facial shape of rabbits were basic symmetry.In the trial and control groups,the conduction velocity of buccal branch was（55.74 ±10.56）m/s and（61.34 ±9.72）m /s and there was no significant difference in both conditions（P0.05）,the quantity of myelinated nerve fibers that distanced grafts distal anastomotic 4.0mm was（18173.62±918.38）n/mm2 and（18601.21±982.31）n/mm2 and there was no significant difference in both conditions（P0.05） too.At the same time,the results of the two groups were also generally similar on electron microscope observation of the neighboring distal nerve of nerve graft.Conclusion Freeze-thaw and chemical acellular allogenic nerve allograft can satisfactory repair a certain length of facial nerve defects,and this is an effective substitute for autologous nerve graft in the repair of facial nerve defects.