内翻静脉移植修复下牙槽神经缺损的动物实验研究

The Experimental Study on Inside-out Vein Graft for Repairing Inferior Alveolar Nerve Defect in the Rabbit

目的 :探索静脉移植修复周围神经缺损的一种新方法 ,进一步提高周围神经修复的效果。方法 :将切取的静脉段的管壁内外翻转成为内翻静脉 ,然后移植修复 8mm的兔下牙槽神经缺损。术后 2 0周 ,采用神经电生理、组织形态学检查与常规静脉移植方法相比较。结果 :术后 2 0周 ,内翻静脉移植在神经兴奋传导速度、再生神经纤维数目及髓鞘厚度上均有明显提高 (P <0 0 5 )。结论 :内翻静脉移植能促进神经再生 ,是一种疗效较好、方法简便的修复周围神经缺损的新方法。

Objective:This study describes a modification of the vein graft technique inside out vein graft, creates an autogenous vein conduct with the collagen rich and Schwann cells exposed to regenerating axons. To compare regeneration of inferior alveolar nerves through two conduits: inside out vein graft and the standard vein graft. Methods: 18 adult white rabbits were selected and vena facialises of both sides were harvested .Turned the right vena facialis into inside out vein and used to bridge an 8mm defect created in the right inferior alveolar nerve. An 8mm defect of the left inferior alveolar nerve was bridged by the standard vein graft. After rabbits sacrified at 8、14 and 20 weeks, the regenerating nerve cables were harvested from the conduits and performed histologic study. At 20 weeks, performed also electrophysiologic studies and statistical analysis of conductive velocities and histological results.Results: Regenerating nerves connected with proximal and distal nerve stumps on both sides postoperation 8 weeks, a number of regenerating nerve fibers and thickness of axon were gradually increasing. At 20 weeks regenerating nerve on the inside out vein graft side showed superior function results—faster conduction velocities (P<0 05) and distinct histological results— much more axon counts (P<0 05) and thicker mylin sheaths (P<0 05) compared with contralateral standard vein graft.Conclusion: The adventital surface of vein promotes nerve regeneration by an environment with collagen rich and Schwann cells. The inside out vein graft is an orginal way to repair inferior alveolar nerve.\;