周围神经侧侧、端侧和端端修复后再生情况的比较：一项实验研究
Comparison of Peripheral Nerve Regeneration with Side-to-side, End-to-side, and End-to-end Repairs: An Experimental Study.
作者信息
Rönkkö Henrikki, Göransson Harry, Taskinen Hanna-Stiina, Paavilainen Pasi, Vahlberg Tero, Röyttä Matias
机构信息
Department of Orthopaedics, Hatanpää City Hospital, Tampere, Finland; Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland; Department of Hand Surgery, Turku University Hospital, Turku, Finland; and §Institute of Clinical Medicine, Department of Biostatistics, and Department of Pathology/ Neuropathology, Turku University Hospital, University of Turku, Turku, Finland.
出版信息
Plast Reconstr Surg Glob Open. 2016 Dec 22;4(12):e1179. doi: 10.1097/GOX.0000000000001179. eCollection 2016 Dec.
BACKGROUND
The present study was conducted to find out a tool to enable improved functional recovery with proximal nerve injury. In this experimental study, nerve regeneration was compared between side-to-side (STS), end-to-side (ETS), and end-to-end repairs.
METHODS
The walk track analysis was used as an outcome of functional recovery. Nerve regeneration was studied with morphometry and histology 6 or 26 weeks postoperatively.
RESULTS
All 3 repair techniques showed regeneration of the nerve. From 12 weeks onward, the functional results of the 3 intervention groups were significantly better compared with the unrepaired control group. End-to-end repair was significantly better when compared with the STS and ETS groups. At 26 weeks, the functional and morphometric results and histologic findings did not differ between the STS and ETS groups. The functional results correlated with the morphometric findings in all groups.
CONCLUSIONS
STS neurorrhaphy showed nerve regeneration, and the end results did not differ from clinically widely used ETS repair. Further studies are warranted to optimize the neurorrhaphy technique and examine possible applications of STS repair in peripheral nerve surgery.
背景
本研究旨在寻找一种能够促进近端神经损伤后功能恢复改善的工具。在本实验研究中，对端侧（STS）、端对端（ETS）和端端修复三种方式下的神经再生情况进行了比较。
方法
采用行走轨迹分析作为功能恢复的指标。在术后6周或26周，通过形态学测量和组织学方法研究神经再生情况。
结果
所有三种修复技术均显示神经发生了再生。从12周起，与未修复的对照组相比，三个干预组的功能结果均显著更好。与STS组和ETS组相比，端端修复的效果显著更佳。在26周时，STS组和ETS组在功能、形态学测量结果及组织学表现方面并无差异。所有组的功能结果均与形态学测量结果相关。
结论
端侧神经缝合显示出神经再生，最终结果与临床上广泛应用的端对端修复并无差异。有必要开展进一步研究以优化神经缝合技术，并探讨端侧修复在周围神经手术中的可能应用。
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