血管化同种异体神经复合体桥接修复兔坐骨神经缺损的实验研究

EXPERIMENTAL RESEARCH ON REPAIRING OF SCIATIC NERVE GAP IN RABBITS WITH REVASCULARIZED ALLOGENOUS NEURAL COMPLEX

目的探讨将经化学去细胞处理的同种异体神经复合体预血管化处理后移植修复兔长段坐骨神经缺损的可行性,以及早期血管化移植体对神经功能恢复的影响。方法将雪旺细胞与血管内皮细胞联合培养后种植于经化学去细胞处理的同种异体神经段中,形成预血管化的神经复合体并将其用于修复兔坐骨神经缺损(实验组),对照组移植体中单纯种植雪旺细胞无血管内皮细胞。术后4、8、16周对2组动物行肌电图检查,观察神经功能恢复情况,然后,手术取材,应用光镜、电镜观察坐骨神经再生和髓鞘形成情况,应用图像分析系统对髓鞘厚度以及有髓神经纤维轴突的直径、数目进行量化分析。结果大体观察,术后4、8、16周2组动物全身及局部均未出现明显的排斥反应。无论是在足部溃疡恢复,还是在神经传导速度、再生神经纤维的数量、超微结构的恢复方面实验组均优于对照组。结论应用预血管化的组织工程人工神经移植体修复兔坐骨神经缺损,能有效地促进受损神经的功能恢复。

Objective To investigate the feasibility and effect of early revascularized allogenous neural complex in repairing rabbit sciatic nerve defect.Methods Schwann cells and vascular endothelial cells were cultured together and transplanted into the chemically extracted acellular allogeneous nerve graft.The pre-revascularized nerve grafts were transplanted into the rabbit defective sciatic nerve （experiment group）.In the control group,only Schwann cells were transplanted in acellular allogeneous nerve grafts.The electrophysiological studies were carried out at 4th,8th,16th week,respectively.After that,the allogenous neural grafts were cut down,the light microscope and transmission electron microscope were performed to observe sciatic nerve regeneration and myelin formation,image analysis system was used to do quantitative analysis on the number of regenerated nerve fibers,axon diameter and the myelin sheath thickness.Results After operation,neither the whole body nor the operating field showed rejective reaction.The experimental group was better than the control group in healing of ulcers,recovery of nerve conduction velocity,the number of nerve fibers and the recovery of ultra structure of medullary sheaths.Conclusion Pre-revascularized allogenous neural complex could significantly promote the functional recovery of injured nerve in repairing rabbit sciatic nerve defect.