面神经损伤后不同修复方法比较

Comparison of different methods of repair of facial nerve injury

目的观测面神经损伤后应用不同修复方法的疗效差异,寻找一种理想的神经修复方法,为临床面神经损伤患者提供治疗依据。方法将50只家兔的左右颊部共100侧随机分成4个实验组。A组:切除5mm面神经颊支,用等长的耳大神经移植。B组:在A组的基础上,于术中、术后第1、2、3、4天分别在局部注入2 000u的神经生长因子(大连司威特制药有限公司制)。C组:切断面神经颊支,原位行端端吻合。N组:对照组。术后饲养12周,对面神经颊支进行神经电生理、组织学检测。结果实验结果证明,再生神经纤维都可以通过神经的吻合端,B﹑C两组在神经传导速度(用江苏产CZ-1000型诱发电位测定仪测定)及组织学上无统计学差异(P>0.01),但与A﹑N两组有统计学差异(P<0.01)。结论神经移植后加用神经生长因子的效果与神经损伤后直接行端端吻合的效果相似。二者的效果明显优于单纯神经移植组。

Objective to observe the difference of different repair for the defect of facial nerve. Researching a kind of ideal medium of nerve repair, to provide the reference of the clinic treatment for patients of facial nerve injury. Methods 100 buccal branches of facial nerve of 50 rabbits were randomly divided into 4 groups. Group A： Grafting the same length great auricular nerve after cutting off buccal branch of facial nerve. Group B： On the base of group A, injecting 2000 U Nerve Growth Factor on the implantation during the operation and 1、2、3、4days separately after the operation. Group C： Repairing the nerve gaps end-to-end, after cutting the buccal branch of facial nerve. Group N： Control group. The animals were fed after operation for 12 weeks. The buccal branch of facial nerve were examined by electrophysiology and histology. Results The rabbit facial nerve regeneration span the anastomotic point. There were not significant difference between group B and group C in nerve conduction velocity and histology, but there were significant difference between group B and group A. Conclusion The result of group B is equal to group C. The result of group B is better than group A.