靶肌肉内注射碱性成纤维细胞生长因子治疗正中神经损伤

Target intramuscular injection with basic fibroblast growth factor for the reparation of median nerve injury

目的:探讨靶肌肉内注射碱性成纤维细胞生长因子结合显微外科技术修复正中神经损伤及预防肌肉萎缩的效果。方法:30例正中神经缺损,行神经显微修复后,平均分为两组,一组为术后靶肌肉注射碱性成纤维细胞生长因子800AU,另一组为靶肌肉注射等量生理盐水,术后1,3,6个月肌电图检查运动神经传导速度,肌肉动作电位幅值,肌纤颤电位波幅,观察肌肉萎缩情况,评估肢体运动感觉功能。结果:靶肌肉注射bFGF组相比对照组在运动神经传导速度上和肌肉动作电位波幅上增加,术后3个月有显著性意义(P<0.05)。术后6个月,bFGF组和对照组的运动感觉功能均获得较高的优良率,分别为93.3%和86.6%,无显著差异(P>0.05)。术后bFGF组相比对照组肌肉萎缩不明显,纤颤电位波幅较低,在术后1、3个月差异有显著性(P<0.05)。结论:靶肌肉内注射碱性成纤维细胞生长因子结合显微外科技术,在早期能明显促进神经再生,延缓肌肉萎缩。

Objective To explore the effects of target intramuscular injection with basic fibroblast growth factor（bFGF） combined with microsurgical technique on the reparation of median nerve injury and on the prevention of muscle atrophy.Methods 30 cases with median nerve injury,who were repaired by nerve microscopic technique,were divided into 2 groups.For bFGF group,800AU of bFGF solution was injected in targeted muscle postoperatively.For control group,equivalent saline was injected in targeted muscle.Motor nerve conduction velocity,muscle evoked action potential,fibrillation potential amplitude,muscular trophy,sensorimotor function were evaluated 1 month,3 months and 6 months after surgery.Results The motor nerve conduction velocity and muscle evoked action potential were higher in bFGF group than those in control group at 3 months after surgery（P 0.05）.The excellent and good rates of both groups were 93.3% and 86.6% at 6 months after surgery（P 0.05）.The muscular trophy was not obvious in bFGF group as compared with that in control group.The fibrillation potential amplitude was lower in bFGF group at 1 month and 3 months after surgery（P 0.05）.Conclusion Target intramuscular injection with bFGF combined with autogenous vein graft conduit nerve microscopic technique can markedly promote nerve regeneration and partly prevent muscle atrophy.