Sames M, Blahos J, Rokyta R, Benes V
Department of Neurosurgery, Masaryk Hospital, Usti nad Labem, Czech Republic.
Physiol Res. 1997;46(4):303-6.
The regeneration of the sciatic nerve after microsuture was compared with the connection of transected nerve with a coagulum of autologous blood plasma in 20 rabbits. The epineuroperineural suture was performed in 10 rabbits (group A). The severed nerve was approximated with fibrin glue of autologous blood plasma in 10 rabbits (group B). Their skin sensation margin during a 3-month-period of regeneration was examined, 90 days after surgery the connection was inspected and the nerve conduction velocity was measured across the site of the anastomosis. The microsuture was found to be firm in all 10 animals of group A. On the other hand, in 2 animals of group B, the glue failed to keep the nerve stumps approximated (dehiscence occurred in 20% of the animals). There were no significant differences found on clinical and electrophysiological testing of regenerated nerves of both groups. The method of autologous fibrin glue in the repair of peripheral nerve transection does not provide a sufficiently firm connection. This procedure with the preparation of the centrifuged plasma is a more time-consuming method in comparison with the microsuture. Epineuroperineural microsuture with maximal effort to adapt the corresponding nerve fibres remains the method of choice for peripheral nerve reconstruction.
在20只兔子身上比较了显微缝合后坐骨神经的再生情况与切断的神经与自体血浆凝块连接后的再生情况。10只兔子进行了神经外膜-神经束膜缝合（A组）。10只兔子用自体血浆纤维蛋白胶使切断的神经对合（B组）。在3个月的再生期内检查它们的皮肤感觉范围，术后90天检查连接情况并测量吻合部位的神经传导速度。发现A组的所有10只动物中显微缝合都很牢固。另一方面，B组有2只动物，胶水未能使神经残端保持对合（20%的动物出现裂开）。两组再生神经的临床和电生理测试未发现显著差异。自体纤维蛋白胶修复周围神经切断术的方法不能提供足够牢固的连接。与显微缝合相比，这种用离心血浆制备的方法更耗时。尽最大努力使相应神经纤维对合的神经外膜-神经束膜显微缝合仍然是周围神经重建的首选方法。
