在有或没有静脉移植的情况下，对预先变性肌肉中周围神经横断伤修复的比较。
Comparison of repair of peripheral nerve transection in predegenerated muscle with and without a vein graft.
作者信息
Mohammadi Jamshid, Delaviz Hamdollah, Mohammadi Bahram, Delaviz Hamoun, Rad Parastou
机构信息
Medicinal Plants Research Centre, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
Cellular and Molecular Research Center, Faculty of Medicine, Yasuj University of Medical Sciences, P.o.Box: 7591994799, Yasuj, Iran.
出版信息
BMC Neurol. 2016 Nov 22;16(1):237. doi: 10.1186/s12883-016-0768-z.
BACKGROUND
Despite substantial research into the topic and valiant surgical efforts, reconstruction of peripheral nerve injury remains a challenging surgery. This study was conducted to evaluate the effectiveness of axonal regeneration of a transected sciatic nerve through a vein conduit containing degenerated skeletal muscle compared with axonal regeneration in a transected sciatic nerve through degenerated skeletal muscle alone.
METHODS
In two of the three experimental rat groups, 10 mm of the left sciatic nerve was transected and removed. The proximal and distal ends of the transected sciatic nerve were then approximated and surrounded with either (a) a degenerated skeletal muscle graft; or (b) a graft containing both degenerated skeletal muscle and vein. In the group receiving the combined vein and skeletal muscle graft, the vein walls were subsequently sutured to the proximal and distal nerve stump epineurium. Sciatic functional index (SFI) was used for assessment of functional recovery. Tracing study and histological procedures were used to assess axonal regeneration.
RESULTS
At 60 days, the gait functional recovery as well as the mean number of myelinated axons in the middle and distal parts of the sciatic nerve significantly increased in the group with the vein graft compared to rats with only the muscular graft (P < 0.05). Mean diameter of myelinated nerve fiber of the distal sciatic nerve was also improved with the vein graft compared to the muscle graft alone (P < 0.05). The mean number of DiI-labeled motor neurons in the L4-L5 spinal segment increased in the vein with muscle group but was not significantly different between the two groups.
CONCLUSIONS
These findings demonstrated that a graft consisting of not only predegenerated muscle, but also predegenerated muscle with vein more effectively supported nerve regeneration, thus promoting functional recovery after sciatic nerve injury in rats.
背景
尽管对该主题进行了大量研究并付出了英勇的手术努力，但周围神经损伤的重建仍然是一项具有挑战性的手术。本研究旨在评估通过含有退变骨骼肌的静脉导管修复横断坐骨神经的轴突再生效果，并与仅通过退变骨骼肌修复横断坐骨神经的轴突再生效果进行比较。
方法
在三个实验大鼠组中的两个组中，切断并切除左侧坐骨神经10毫米。然后将近端和远端横断的坐骨神经对接，并分别用以下材料包裹：(a) 退变骨骼肌移植物；或(b) 含有退变骨骼肌和静脉的移植物。在接受静脉和骨骼肌联合移植物的组中，随后将静脉壁缝合到近端和远端神经残端的神经外膜上。使用坐骨神经功能指数（SFI）评估功能恢复情况。通过追踪研究和组织学方法评估轴突再生情况。
结果
60天时，与仅接受肌肉移植物的大鼠相比，接受静脉移植物的组中，步态功能恢复以及坐骨神经中、远端有髓轴突的平均数量显著增加（P < 0.05）。与仅接受肌肉移植物相比，接受静脉移植物的组中坐骨神经远端有髓神经纤维的平均直径也有所改善（P < 0.05）。L4-L5脊髓节段中DiI标记的运动神经元的平均数量在肌肉加静脉组中增加，但两组之间无显著差异。
结论
这些发现表明，不仅由退变肌肉组成，而且由退变肌肉和静脉组成的移植物能更有效地支持神经再生，从而促进大鼠坐骨神经损伤后的功能恢复。
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