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止血剂和组织粘合剂对大鼠外周神经损伤愈合的影响——第一部分。电生理研究。

The effect of hemostatic agents and tissue adhesive on injured peripheral nerve healing in rats - Part I. Electrophysiological study.

作者信息

Sener Ismail, Bereket Cihan, Arslan Gökhan, Özkan Nilüfer, Özdemir Muhsin, Mercan Uğur, Ayyildiz Mustafa, Agar Erdal

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.

Department of Physiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.

出版信息

Adv Clin Exp Med. 2015 Jan-Feb;24(1):23-9. doi: 10.17219/acem/38157.

Abstract

BACKGROUND

In the practice of maxillofacial surgery, bleeding and nerve injury have common problems. In the control of bleeding, hemostatic agents and tissue adhesives have been frequently used. The effect of these hemostatic agents and tissue adhesives on the injured neural tissues has not been known.

OBJECTIVES

In this study, we aimed to investigate the effects of hemostatic agents and tissue adhesive on injured nerve tissues.

MATERIAL AND METHODS

Forty-two rats randomly divided into seven groups: Control, Oxidized Regenerated Cellulose (ORC), Gelatine Sponge (GS), Bovine Collagen (BC), Ankaferd BloodStopper (ABS), Glutaraldehyde Surgical Adhesive (BioGlue®) and N-butil-2 cyanoacrylate (Glubran®2). The left sciatic nerves were crushed and surrounded by hemostatic agents and tissue adhesives. At the end of 12 weeks, the surgical site was reopened and electrophysiological recordings were performed.

RESULTS

In the ORC, GS, and BC groups, the compound action potential (CAP) values were lower compared to the control group (p < 0.05). Although the values of CAP in the ABS group were higher than in the control group while CAP values in the BioGlue and Glubran®2 groups were lower than the control group, there was no statistical significance between the experimental and control groups (p > 0.05). In the ORC, BC, GS, and Glubran®2 groups, the nerve conduction velocities (NCV) values were lower than in the control group (p < 0.05). In the ABS and BioGlue groups, NCV values were lower compared to the control group but no significant differences were found (p > 0.05).

CONCLUSIONS

The present study provides evidence that ABS is the most suitable hemostatic agent due to its favorable effect on the healing of injured neural tissues. BioGlue is also a suitable surgical agent with no adverse effects.

摘要

背景

在颌面外科手术实践中,出血和神经损伤是常见问题。在控制出血方面,止血剂和组织粘合剂被频繁使用。这些止血剂和组织粘合剂对受损神经组织的影响尚不清楚。

目的

本研究旨在探讨止血剂和组织粘合剂对受损神经组织的影响。

材料与方法

42只大鼠随机分为七组:对照组、氧化再生纤维素(ORC)组、明胶海绵(GS)组、牛胶原蛋白(BC)组、安卡福得止血剂(ABS)组、戊二醛手术粘合剂(BioGlue®)组和正丁基-2-氰基丙烯酸酯(Glubran®2)组。将左侧坐骨神经挤压后,用止血剂和组织粘合剂包裹。12周结束时,重新打开手术部位并进行电生理记录。

结果

在ORC组、GS组和BC组中,复合动作电位(CAP)值低于对照组(p < 0.05)。虽然ABS组的CAP值高于对照组,而BioGlue组和Glubran®2组的CAP值低于对照组,但实验组和对照组之间无统计学意义(p > 0.05)。在ORC组、BC组、GS组和Glubran®2组中,神经传导速度(NCV)值低于对照组(p < 0.05)。在ABS组和BioGlue组中,NCV值低于对照组,但未发现显著差异(p > 0.05)。

结论

本研究提供的证据表明,ABS因其对受损神经组织愈合有良好作用,是最合适的止血剂。BioGlue也是一种合适的手术制剂,无不良影响。

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