生物套管小间隙桥接修复周围神经的实验研究

Using biological tube for bridging the peripheral nerve defect with a small gap: an experimental study

目的 探讨用部分脱乙酰甲壳质生物套管小间隙桥接修复周围神经损伤的可行性。方法 将SD大鼠双侧坐骨神经切断后 ,按手术方法随机分为 5组。A组 :神经外膜原位缝合 (n =10 ) ;B组 :生物套管小间隙原位桥接 (n =10 ) ;C组 :断端旋转 180°外膜缝合 (n =10 ) ;D组 :断端旋转 180°生物套管小间隙桥接 (n =10 ) ;N组 :正常对照 (n =10 )。术后 6周行电生理学检查 ,光镜下作再生有髓神经纤维计数。结果 A、B、D组的运动神经传导速度快于C组但慢于N组 ,5组间差异无显著意义 (P >0 .0 5 )。有髓神经纤维计数数目 ,A >B >D >C >N组 ,A、B、D组与C组相比 ,两者差异有显著意义 (P <0 .0 1,P<0 .0 5 ) ;但A、B、D 3组间的差异无显著意义 (P >0 .0 5 )。结论 部分脱乙酰甲壳质生物套管小间隙桥接修复周围神经的效果好于断端转位的外膜缝合 ,具有替代外膜缝合的可行性。

Objective To investigate the possibility of bridging small peripheral nerve gap using a partial de acetyl chitosan tube. Methods The sciatic nerves of both sides at SD rats were cut. They were allocated into 5 groups landomly. Group A: epineurium suture in situ (n=10); group B: biological tube for bridging the peripheral nerve defect with a small gap (n=10); group C: epineurium suture with distal stump rotated 180°(n=10); group D: bridging the nerve by biological tube with a small gap, but the distal stump rotated 180°(n=10); group N: normal control(n=10). On the 6 weeks after operation, electrophysiological examination was done. The myelinated axon count was calculated under the light microscope. Results The nerve conduction velocity in group A,B,D was faster than in group C but slower than in group N. There was no statistically significant difference among 5 groups. The results of myelinated axon count showed as follows: A > B > D > C > N. There was statistical significant difference between group A,B,D and group C. However, no difference was found among group A,B and D. Conclusion The results of partial de acetyl chitosan tube for bridging nerve defect with a small gap were superior to that with epineurium suture with distal stump rotated. This new methods may be possible to substitute epineurium suture.