Kou Yu-Hui, Yu You-Lai, Zhang Ya-Jun, Han Na, Yin Xiao-Feng, Yuan Yu-Song, Yu Fei, Zhang Dian-Ying, Zhang Pei-Xun, Jiang Bao-Guo
Peking University People's Hospital, Beijing, China.
The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Neural Regen Res. 2019 Apr;14(4):706-712. doi: 10.4103/1673-5374.247475.
During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining. There was no obvious inflammatory reaction and neuroma formation in the tibial nerve after repair by the small gap bio-sleeve suture with different inner diameters at both ends. The conduction velocity, muscle strength, wet muscle weight, cross-sectional area of muscle fibers, and the number of new myelinated nerve fibers in the bio-sleeve suture group were similar to those in the epineurial neurorrhaphy group. Our findings indicate that small gap bio-sleeve suture with different inner diameters at both ends can achieve surgical suture between nerves of different diameters and promote regeneration and functional recovery of injured peripheral nerves.
在周围神经转位修复术中，如果转位神经之间的直径差异较大，或者必须同时修复多条远端神经，传统的神经外膜缝合术在缝合部位存在高张力问题，甚至可能导致神经缝合失败。我们研究了两端内径不同的小间隙生物套管缝合术是否可用于通过大鼠腓总神经近端转位修复2毫米的胫神经缺损，并将结果与神经外膜缝合术后的修复情况进行比较。术后三个月，使用胫神经功能指数、神经电生理测试、肌肉生物力学和湿重测量、锇酸染色和苏木精-伊红染色来评估神经功能、神经再生和神经支配肌肉的恢复情况。两端内径不同的小间隙生物套管缝合术修复胫神经后，未出现明显的炎症反应和神经瘤形成。生物套管缝合组的传导速度、肌肉力量、湿肌肉重量、肌纤维横截面积和新生有髓神经纤维数量与神经外膜缝合组相似。我们的研究结果表明，两端内径不同的小间隙生物套管缝合术可实现不同直径神经之间的手术缝合，并促进受损周围神经的再生和功能恢复。
