睫状神经生长因子应用于舌缺损功能重建的实验研究

发布时间：2018-05-16 05:59

本文选题：舌重建 + 睫状神经生长因子　；参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：建立携带肋间神经的腹直肌-腹膜瓣修复舌缺损的比格犬动物模型,.将肋间神经与舌下神经吻合,通过观察应用与不应用睫状神经生长因子(ciliary neurotrophic factor, CNTF),评价再生神经数量及功能恢复差异,为功能性舌重建提供实验依据。方法：将18只健康雄性比格犬,犬龄1-1.5岁,分别编号,按随机数字表分为两组(A、B组),每组9只。首先两组在舌体左侧制备舌缺损,以左下第一磨牙近中至舌中线的垂直连线为前界切除4cm×3cm范围的舌体组织,然后两组分别制备携带第11肋间神经和腹壁下动、静脉的腹直肌-腹膜瓣。将第11肋间神经和舌下神经吻合,腹壁下动、静脉分别与舌动脉、颌外静脉吻合,腹直肌-腹膜瓣修复舌缺损。两组神经吻合段均置于硅胶管内,两端以胶原蛋白海绵封闭。吻合完成后A组硅胶管内一次性注入CNTF300ng(5ul,60ng/ul), B组硅胶管内注入5u1生理盐水。术后12周,两组动物模型进行舌下神经电生理检测,再生神经有髓纤维、运动纤维计数,神经直径、移植腹直肌细胞直径、面积测量。结果：电生理检测结果为A、B两组潜伏期较正常明显延长,A组潜伏期较B组短,A、B两组振幅较正常降低,A组振幅大于B组,A、B两组传导速度较正常减慢,A组传导速度恢复优于B组,差异均有统计学意义(P0.05)；A、B两组再生神经直径,有髓纤维、运动纤维计数比较,A组再生神经直径、有髓神经纤维、运动神经纤维数量大于B组,差异均有统计学意义(P0.05)；A、B两组转移腹直肌细胞比较,A组细胞直径、面积大于B组,差异均有统计学意义(P0.05)。结论：携带肋间神经的腹直肌腹膜瓣转移修复舌缺损后,两组模型肋间神经可重获舌下神经支配,局部应用CNTF可促进运动神经再生,舌下神经功能恢复优于未使用CNTF组,并能有效防止转移腹直肌腹膜瓣萎缩
[Abstract]:Objective: to establish a biger dog model of repairing tongue defect with rectus abdominis and peritoneal flap carrying intercostal nerve. The intercostal nerve and hypoglossal nerve were anastomosed to evaluate the difference in the number and function of regenerated nerve by observing the application and non-application of ciliary nerve growth factor (ciliary neurotrophic factor) in order to provide experimental basis for functional tongue reconstruction. Methods: eighteen healthy male Beagle dogs aged 1 to 1.5 years old were divided into two groups according to the random number table, 9 in each group. At first, the tongue defect was prepared on the left side of the tongue body. The vertical line from the middle to the middle line of the left first molar was used as the anterior boundary to remove the tongue tissue in the 4cm 脳 3cm area. Then, the second group was prepared to carry the 11th intercostal nerve and the inferior abdominal wall movement, respectively. Rectus abdominis-peritoneal flap of vein. The 11th intercostal nerve was anastomosed with hypoglossal nerve, inferior abdominal artery and vein were anastomosed with lingual artery, external maxillary vein and rectus abdominis peritoneum flap respectively to repair tongue defect. The nerve anastomoses of the two groups were placed in a silicone tube and closed with collagen sponge at both ends. After the anastomosis was completed, CNTF 300 ng / L 5 ulng / L was injected into the silicone tube in group A and 5u1 saline was injected into the silicone tube in group B. 12 weeks after operation, the hypoglossal nerve electrophysiological examination was performed in the two groups. The regenerated nerve myelinated fiber, motor fiber count, nerve diameter, the diameter and area of the transplanted rectus abdominis cells were measured. Results: the results of electrophysiological examination showed that the latency of group A was shorter than that of group B, the amplitude of group A was lower than that of group B, the amplitude of group A was larger than that of group B and the conduction velocity of group A was lower than that of group B. The recovery of conduction velocity in group A was better than that in group B. There were significant differences in the diameter of regenerated nerve and the number of myelinated fibers in group A, and the number of regenerated nerve fibers, myelinated nerve fibers and motor nerve fibers in group A were higher than those in group B. There were significant differences in the diameter and area of metastatic rectus abdominis cells in group A and group B, and the difference was statistically significant (P 0.05). Conclusion: after the transfer of rectus abdominis peritoneal flap carrying intercostal nerve to repair tongue defect, the intercostal nerve of the two groups can regain the hypoglossal nerve innervation, local application of CNTF can promote the regeneration of motor nerve, and the recovery of hypoglossal nerve function is better than that of non-CNTF group. It can effectively prevent rectus abdominis from atrophy.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.57

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