人胎盘羊膜包裹的脱细胞同种异体神经移植修复犬坐骨神经缺损

Human placenta amniotic membrane wrap chemically extracted acellular nerve allograft repair of canine nerves

目的:探讨人胎盘羊膜包裹的脱细胞同种异体神经移植技术的可行性。方法:12只犬分为脱细胞同种异体神经移植组和人胎盘羊膜包裹的脱细胞同种异体神经移植(B)组,每组6只,均建立坐骨神经缺损动物模型。制备人胎盘羊膜和脱细胞同种异体神经。A和B组分别行同种异体神经移植术和人胎盘羊膜包裹的同种异体神经移植术。术后16周运用电生理学、髓鞘HE染色等观察2组犬移植段神经比目鱼肌诱发电位的波幅和时限、双侧坐骨神经传导速度的差异。结果:术后16周,A组犬足部及小腿红肿;B组犬神经功能恢复,小腿肌肉肌力恢复,犬右后肢能够站立。A和B组犬移植段神经连续性好,B组犬移植段神经周围炎症反应轻。B组与A组相比可见较多雪旺细胞增殖及大量再生的神经纤维。B组轴突密度和比目鱼肌诱发电位波幅、时限明显高于A组(t=10.195、4.825和6.323,P<0.001)。结论:人胎盘羊膜包裹的脱细胞同种异体神经移植术可改善神经形态学变化,提高移植神经的修复质量。

Aim ：To explore the possibility of bridging the sciatic nerve defects with the allografts wrapped with human placenta amnion membrane in canines. Methods：According to allografts used in the operative, the canines were divided in- to two groups：allografts used to repair nerve defects as group A; human placenta amniotic membrane wrapped allografts used to repair nerve defects as group B. 16 weeks after operation,the general healthy state of the canines and the morpholo- gy of nerves transplanted were observed,the amplitude and time limit of soleus muscle action potential and nerve conduction velocity of experiment canines were tested by electrophysiology. Results：16 weeks after operation,the foot and leg in chron- ically inflamed in group A;the transplanting nerve function resumed and canine right hind could stand in group B. There were more Schwann cells and nerve fiber in group B. Density of axons counts,the amplitude and time limit of soleus muscle action potential were increased in group B than those in group A（t = 10. 195,4. 825,6. 323 ,P 〈 0. 001 ）. Conclusion ：A1- lografts wrapped with human amnion membrane through chemical extraction is better than normal allografts.