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带血管神经移植物与传统神经移植物再生情况的比较:病例报告

Comparison of regeneration across a vascularized versus conventional nerve graft: case report.

作者信息

Mackinnon S E, Kelly L, Hunter D A

机构信息

Department of Surgery, University of Toronto, Ontario, Canada.

出版信息

Microsurgery. 1988;9(4):226-34. doi: 10.1002/micr.1920090403.

Abstract

A histological and functional comparison of regeneration across a vascularized and conventional nerve graft was carried out in a clinical case. The two branches of the medial antebrachial cutaneous nerve were used to neurotize the median nerve at the wrist. The superficial branch of the radial nerve (vascularized nerve graft) and a conventional sural nerve graft were used as the interposition grafts between the two branches of the medial antebrachial cutaneous nerve and the median nerve. This nerve grafting procedure was carried out in two stages. The proximal neurorrhaphy was carried out 7 months prior to the distal nerve repair. Biopsies were taken from the distal portions of the vascularized radial sensory nerve and the conventional sural nerve at the time of the second procedure. Histological evaluation demonstrated superior regeneration across the vascularized nerve graft. Subjectively, the patient described better sensory recovery in the territory innervated by the vascularized nerve graft. Sensory testing in the two territories demonstrated better sensibility in the territory innervated by the vascularized nerve graft.

摘要

在一个临床病例中,对通过带血管神经移植物和传统神经移植物的再生进行了组织学和功能比较。使用前臂内侧皮神经的两个分支在腕部对正中神经进行神经移植。桡神经浅支(带血管神经移植物)和传统的腓肠神经移植物被用作前臂内侧皮神经两个分支与正中神经之间的移植桥接物。该神经移植手术分两个阶段进行。近端神经缝合在远端神经修复前7个月进行。在第二次手术时,从带血管桡感觉神经和传统腓肠神经的远端部分取活检组织。组织学评估显示通过带血管神经移植物的再生效果更好。主观上,患者描述在由带血管神经移植物支配的区域感觉恢复更好。对两个区域的感觉测试表明,在由带血管神经移植物支配的区域感觉更敏锐。

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