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[神经吻合。缝线还是纤维蛋白胶?初步结果]

[Nerve anastomoses. Sutures or fibrinogenic glue? Preliminary results].

作者信息

Boedts D, Bouckaert J I

出版信息

Acta Otorhinolaryngol Belg. 1984;38(2):107-12.

PMID:6385609
Abstract

A comparative animal experiment was set up between two nerve anastomosis techniques, one by sealing nerve ends with a fibrinogen-thrombine glue and the other by classical perineural suturing. It was concluded that glueing nerve ends, from the surgical-technical point of view is a better method than suturing. It is an easy, time-sparing method which allows excellent coaptation of the severed nerves with minimal iatrogenic trauma. On the long run however some questions remain. There is the problem of induced fibrosis by using high doses of aprotinine and factor XIII at the site of the nerve junctions and on the other hand the influence of fibrinolysis in traumatized tissues, with early decrease of tensile strength at the junctions before nerve healing. So glued nerve ends should be completely free of tension, protected against secondary shearing forces, and also immobilization of the region is required.

摘要

在两种神经吻合技术之间开展了一项对比动物实验,一种是用纤维蛋白原-凝血酶胶封闭神经断端,另一种是采用经典的神经外膜缝合。得出的结论是,从外科技术角度来看,粘合神经断端是比缝合更好的方法。这是一种简便、省时的方法,能使离断神经实现极佳的对接,同时医源性创伤最小。然而,从长远来看,仍存在一些问题。在神经连接处使用高剂量抑肽酶和因子 XIII 会引发纤维化问题,另一方面,创伤组织中的纤维蛋白溶解也有影响,会导致在神经愈合前连接处的抗张强度早期下降。因此,粘合的神经断端应完全无张力,防止受到二次剪切力,并且该区域也需要固定。

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