神经牵拉延长器修复神经缺损的实验研究

The Experimental Study on Repairing for Rabbits Sciatic Nerve Defect with Self designed Elongater

目的 :探讨神经牵拉延长器修复神经缺损 ,为临床应用提供依据。方法 :健康家兔 3 0只 ,分 3组 ,右侧坐骨神经造成 1.0cm缺损 ,A组 :自制神经牵拉延长器延长 ,二期端 -端缝合 ;B组 :神经原位移植 ;C组 :直接拉拢缝合。术后不同时期分别进行电生理、组织学、神经纤维计数等检查。结果 :①神经牵拉延长器直接牵拉延长修复神经缺损是可行的 ;②神经牵拉延长器修复神经缺损和自体神经原位移植比较差异无显著性。结论 :神经牵拉延长器是修复神经缺损的一种新方法。

Objective: To study the nerve elongater technique in repairing segmental nerve defect for the clinical application. Methods: 30 healthy rabbits were randomly divided into three groups. Right side 1.0cm segmental sciatic nerve defects were created in rabbits. In the first group, 1.0cm segment was excised and elongated with a nerve elongater designed by the authers and then repaired with end to end suture. In the second group. 1.0cm neurotomy was performed and the segment was repaired without removal from the bed. In the third group 0.8cm defect was created and the defect was repaired tensively with 10\0 nylon thread without nerve graft. Ten weeks later nerve conduction velocity (NCV), the amplitude of nerve active potential were determined. Twenty weeks later macroscopic and microscopic or electron microscopic histological study and electrophysiologic testing and image analysis of nerve transverse sections were taken. Results: 1) nerve elongater technique can be used successfully to repair sebmental peripheral nerve defects;2) nerve elongation repair was comparable to conventional nerve autografts. There was no difference in nerve conduction velocity, histology and inage anaysis. Conclusions: nerve elongation may prove to be a useful alternative to grafting.