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壳聚糖中空管与自体神经移植修复周围神经缺损效果的比较:一项实验研究。

Comparison of results between chitosan hollow tube and autologous nerve graft in reconstruction of peripheral nerve defect: An experimental study.

作者信息

Shapira Yuval, Tolmasov Michael, Nissan Moshe, Reider Evgeniy, Koren Akiva, Biron Tali, Bitan Yifat, Livnat Mira, Ronchi Giulia, Geuna Stefano, Rochkind Shimon

机构信息

Division of Peripheral Nerve Reconstruction, Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Israel.

Department of Anesthesiology, Tel Aviv Sourasky Medical Center, Israel.

出版信息

Microsurgery. 2016 Nov;36(8):664-671. doi: 10.1002/micr.22418. Epub 2015 Apr 22.

Abstract

OBJECT

This study evaluated a chitosan tube for regeneration of the injured peripheral nerve in a rodent transected sciatic nerve model in comparison to autologous nerve graft repair.

METHODS

Chitosan hollow tube was used to bridge a 10-mm gap between the proximal and distal ends in 11 rats. In the control group, an end-to-end coaptation of 10-mm long autologous nerve graft was performed in 10 rats for nerve reconstruction.

RESULTS

SFI showed an insignificant advantage to the autologous group both at 30 days (P = 0.177) and at 90 days post procedure (P = 0.486). Somato-sensory evoked potentials (SSEP) and compound muscle action potentials (CMAP) tests showed similar results between chitosan tube (group 1) and autologous (group 2) groups with no statistically significant differences. Both groups presented the same pattern of recovery with 45% in group 1 and 44% in group 2 (P = 0.96) showing SSEP activity at 30 days. At 90 days most rats showed SSEP activity (91% vs.80% respectively, P = 0.46). The CMAP also demonstrated no statistically significant differences in latency (1.39 ms in group 1 vs. 1.63 ms in group 2; P = 0.48) and amplitude (6.28 mv vs. 6.43 mv respectively; P = 0.8). Ultrasonography demonstrated tissue growth inside the chitosan tube. Gastrocnemius muscle weight showed no statistically significant difference. Histomorphometry of the distal sciatic nerve, 90 days post reconstructive procedure, showed similar number of myelinated fibers and size parameters in both groups (P ≥ 0.05).

CONCLUSIONS

Chitosan hollow tube used for peripheral nerve reconstruction of rat sciatic nerve showed similar results in comparison to autologous nerve grafting. © 2015 Wiley Periodicals, Inc. Microsurgery 36:664-671, 2016.

摘要

目的

本研究在啮齿动物坐骨神经横断模型中,评估壳聚糖管用于损伤周围神经再生的效果,并与自体神经移植修复进行比较。

方法

使用壳聚糖空心管桥接11只大鼠坐骨神经近端和远端之间10毫米的间隙。对照组中,对10只大鼠进行10毫米长的自体神经移植端端吻合以重建神经。

结果

功能指数(SFI)在术后30天(P = 0.177)和90天(P = 0.486)时,显示出相对于自体移植组无显著优势。体感诱发电位(SSEP)和复合肌肉动作电位(CMAP)测试表明,壳聚糖管组(第1组)和自体移植组(第2组)之间结果相似,无统计学显著差异。两组呈现相同的恢复模式,第1组在30天时SSEP活性为45%,第2组为44%(P = 0.96)。在90天时,大多数大鼠显示出SSEP活性(分别为91%和80%,P = 0.46)。CMAP在潜伏期(第1组为1.39毫秒,第2组为1.63毫秒;P = 0.48)和波幅(分别为6.28毫伏和6.43毫伏;P = 0.8)方面也无统计学显著差异。超声检查显示壳聚糖管内有组织生长。腓肠肌重量无统计学显著差异。重建手术后90天,坐骨神经远端的组织形态计量学显示两组有髓纤维数量和大小参数相似(P≥0.05)。

结论

用于大鼠坐骨神经周围神经重建的壳聚糖空心管与自体神经移植相比,结果相似。©2015威利期刊公司。显微外科手术36:664 - 671,2016。

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