Zhang Pei-xun, Jiang Bao-guo, Zhao Fu-qiang, Fu Zhong-guo, Zhang Dian-ying, Du Chan, Zhang Hong-bo
Department of Trauma and Orthopedics, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2005 Oct 15;43(20):1344-7.
To investigate the possibility of bridging small peripheral nerve gap using a de-acetyl chitosan conduit.
The sciatic nerves of right sides were cut at SD rats. They were divided into 5 Groups randomly; Group A: epineurium suture in situ (n = 24); Group B: biological conduit with a small gap for bridging the peripheral nerve (n = 24, with 5 mm gap); Group C: epineurium suture with distal stump rotated 180 degrees (n = 24); Group D: bridging the nerve by biological conduits with a small gap, but the distal stump rotated 180 degrees (n = 24, with 5 mm gap); Group E: biological conduit with a small gap for bridging the peripheral nerve with NGF (n = 24). Electrophysiological examination, histological examination and myelinated axon counting were applied after 2, 4, 6, 8 weeks after operation respectively.
Regenerated nerve fibers were seen in the distal nerve segments of all 5 groups; The nerve conduction velocity of small gap group (group B, D) was faster than that of corresponding simple epineurium suture group (group A, C) at all 2, 4, 6, 8 week time point (P < 0.05). The myelinated axon counting of small gap group (group B, D) was faster than that of corresponding simple epineurium suture group (group A, C) at all 4, 6, 8 week time point (P < 0.01), and there was no statistically significant difference at 2 week time point.
The repair effects of chitin conduit bridging peripheral nerve with small gap (5 mm) are better than that of epineurium suture directly, and possess the potential to substitute the epineurium suture.
探讨使用脱乙酰壳聚糖导管桥接周围小神经间隙的可能性。
将SD大鼠右侧坐骨神经切断。随机分为5组;A组:原位神经外膜缝合(n = 24);B组:用生物导管桥接周围神经并留小间隙(n = 24,间隙5 mm);C组:神经外膜缝合且远侧断端旋转180度(n = 24);D组:用生物导管桥接神经并留小间隙,但远侧断端旋转180度(n = 24,间隙5 mm);E组:用含神经生长因子(NGF)的生物导管桥接周围神经并留小间隙(n = 24)。分别于术后2、4、6、8周进行电生理检查、组织学检查及有髓轴突计数。
所有5组远侧神经段均可见再生神经纤维;在术后2、4、6、8周的所有时间点,小间隙组(B组、D组)的神经传导速度均快于相应单纯神经外膜缝合组(A组、C组)(P < 0.05)。在术后4、6、8周的所有时间点,小间隙组(B组、D组)的有髓轴突计数均快于相应单纯神经外膜缝合组(A组、C组)(P < 0.01),在术后2周时间点无统计学差异。
几丁质导管桥接5 mm小间隙周围神经的修复效果优于直接神经外膜缝合,具有替代神经外膜缝合的潜力。