关于坐骨神经再生的机理

发布时间：2018-06-13 02:02

本文选题：HHK + 坐骨神经　；参考：《第一军医大学》2005年博士论文

【摘要】：周围神经损伤和缺损的治疗是显微外科的难题之一。不少学者从不同角度,采用多种方法进行了有益的探索,取得了很大的进展。近年来,随着组织工程学的兴起,对周围神经缺损的修复探索出一条解决问题的捷径。研制可生物降解的人工神经套管,将此套管植入缺损神经的近端和远端之间,将两端神经连接起来,在它们之间构建一个有利于神经再生的“微环境”,诱导损伤神经的再生与修复,将是很有前途的方法。目前,用于套接的材料很多,分两大类,一类是合成材料,另一类是天然材料。劳杰等证明用硅胶管,并辅以施万细胞,能诱导正中神经再生。硅胶管有制备方便、不塌陷的优点,但术后会产生致命的神经卡压现象及炎性刺激,另外需要再次手术取出,所以并不适合临床应用。静脉管壁做为套管容易塌陷,而且其中的成纤维细胞易形成疤痕,阻碍神经生长。胶原膜套管具有排异反应小,可吸收、存储方便的特点,适合临床应用。王光林等以雪旺细胞与PLA构建组织工程化人工神经,修复周围神经缺损的效果接近于自体神经移植。我校自1991年以来,采用经序贯生物化学特殊处理的人发角蛋白(humanhair keratin,HHK)为医学生物材料,成功研制出HHK人工腱。经动物实验与临床应用证明,该人工腱不仅具有其它传统医用材料的生物学特性,而且还具有以下特点:组织相容性好;可完全降解吸收,并能诱导形成具有正常功能的自体腱形成,从而表明HHK可以作为一种新型的医用生物材料应用于临床。
[Abstract]:The treatment of peripheral nerve injury and defect is one of the difficult problems in microsurgery. Many scholars have made great progress by using various methods from different angles. In recent years, with the rise of tissue engineering, the repair of peripheral nerve defects to explore a shortcut to solve the problem. A biodegradable artificial nerve cannula was developed. The cannula was implanted between the proximal and distal ends of the defective nerve, and the two ends of the nerve were connected to form a "microenvironment" conducive to nerve regeneration. It is a promising method to induce nerve regeneration and repair. At present, there are many kinds of materials for socket, one is synthetic material, the other is natural material. Lauger et al proved that the median nerve regeneration could be induced by silica gel tube supplemented with Schwann cells. Silicone tube has the advantages of convenient preparation and not collapse, but it will produce fatal nerve compression and inflammatory stimulation after operation, and need to be removed again, so it is not suitable for clinical application. The venous wall is prone to collapse as a cannula, and the fibroblasts are prone to scar formation, hindering nerve growth. Collagen membrane cannula is suitable for clinical application because of its advantages of small rejection, absorbability and convenient storage. Wang Guanglin used Schwann cells and PLA to construct tissue engineered artificial nerve, and the effect of repairing peripheral nerve defect was similar to that of autogenous nerve transplantation. Since 1991, HHK artificial tendon was successfully developed using human hair keratin HHKK (human hair keratin) treated by sequential biochemistry as medical biomaterial. Animal experiments and clinical applications have proved that the artificial tendon not only has the biological characteristics of other traditional medical materials, but also has the following characteristics: good histocompatibility, complete degradation and absorption. It can induce the formation of autologous tendon with normal function, which indicates that HHK can be used as a new medical biomaterial in clinic.
【学位授予单位】：第一军医大学
【学位级别】：博士
【学位授予年份】：2005
【分类号】：R322

【参考文献】