不同途径注射鼠神经生长因子对断指再植术后感觉恢复的疗效评估

Assessment of the efficacy of different injecting approaches of mouse nerve growth factor on sensory function restoration after replantation of amputated fingers

目的:探讨不同途径注射鼠神经生长因子(nerve growth factor,NGF)对断指再植术后感觉恢复的影响。方法:将断指再植成活59例66指纳入本研究,随机分为鞘膜内注射组、肌肉注射组及对照组。鞘膜内注射组于神经鞘膜内一次性注射NGF 7.5μg。肌肉注射组术后每日臀部肌肉注射NGF 30μg,连续14 d。对照组局部及全身均未使用神经营养药物。术后3、6个月随访,测定患指指端两点分辨觉距离。结果:术后3个月鞘膜内注射组优于其他2组,差异具有显著性(P<0.05)。术后6个月鞘膜内注射组与肌肉注射组比较疗效无明显差异(P>0.05),但均优于对照组(P<0.05)。结论:NGF能促进断指再植术后感觉功能恢复,神经鞘膜内注射NGF早期疗效优于肌肉注射。

Objective To explore the effect of different injecting approaches of mouse nerve growth factor （NGF） on sensory function restoration after replantation of amputated fingers. Methods 59 cases with total 66 replantation fingers were randomly divided into the nerve sheath film injection group, the intramuscular injection group and the control group. In the nerve sheath film injection group, 7.5 μg NGF was injected one-off in the operations. In the intramuscular injection group, 30 μg NGF was injected everyday after operations, 14 days continuously. The control group had no nerve growth medicine. Two-point discrimination at the fingertip was evaluated in the 3rd and 6th month after operations, and use the UK medical research council assessment standard rating （1954）. Results After operations, the grades of nerve sheath film injection group were higher than the other two groups （P 〈 0.05） in the 3rd month. The grades were no statistically significant difference between the nerve sheath film injection group and the intramuscular injection group （P 〉 0.05 ）, and the grades of two groups were both higher than the control group （P 〈 0.05）. Conclusion NGF can significantly enhance the recovery of sensory function after replantation of amputated fingers, and early effect of injecting approach of nerve sheath film is better than intramuscular injection.