不同长度神经片段串联再生室对兔坐骨神经再生的影响

Experimental study on chamber of different lengths nerve Fragments in series effects the rabbit sciatic nerve regeneration

目的探讨选取损伤神经远端的不同长度自体神经片段串联壳聚糖-胶原-CNTF再生室对兔坐骨神经再生的影响。方法将40只日本大白兔随机分为四组,A、B、C组(实验组)及D组(对照组),每组10只。A组:4mm自体神经片段串联再生室组;B组:6mm自体神经片段串联再生室组;C组:8mm自体神经片段串联再生室组;D组:自体神经移植组。术后16周观察电生理、腓肠肌湿重、组织学、电镜及图像分析结果。结果术后16周B、C、D组在神经传导速度、腓肠肌湿重百分比的比较差异无统计学意义,均优于A组,且差异有统计学意义(P<0.05)。术后16周再生神经纤维数目、直径及髓鞘厚度的比较,四组在近端处比较差异无统计学意义,在远端处B、C、D组间比较差异无统计学意义,均优于A组,且差异有统计学意义(P<0.05)。结论选取损伤神经远端自体神经片段串联再生室对修复周围神经缺损的作用明显,6mm组和8mm组优于4mm组,且效果都近似于自体神经移植,但6mm组节省神经,是最为适宜的自体神经片段长度。

【Objective】 Select the nerve damage of the distal nerve fra-gments of different lengths in series chitosan-collagen-CNTF chamber of the rabbit sciatic nerve regeneration.【Methods】 Forty Japanese white rabbits were randomized in four groups of 10,A： 6mm nerve fragment in series chamber group;B： 8mm nerve fragment in series chamber group;C： 10mm nerve fragment in series chamber group;D： nerve autograft group.General observation at different times after surgery,and after 16 weeks in electrophysiology,gastrocnemius wet weight,histology,electron microscopy and image analysis evaluation of nerve regeneration.【Results】 16 weeks after B,C,D groups in nerve conduction velocity,gastrocnemius wet weight percentage of the difference was not statistically significant,are better than group A,and the difference was statistically significant（P0.05）.16 weeks after operation the number of regenerating nerve fibers,diameter and thickness of the myelin sheath compared four groups in the proximal difference was not statistically significant,in the remote office B,C,D between the two groups no significant difference,are excellent in group A,and the difference was statistically significant（P0.05）.【Conclusion】 The regeneration chamber which selected from autologous nerve in injury distal nerve has obvious effect in repairing peripheral nerve defects,6mm and 8mm group is better than 4mm group.Besides,the results are similar to the autologous nerve graft.But the 6mm group has the advantage of saving nerves,which is the most suitable autologous nerve fragment length.