血管支架支撑静脉神经导管修复兔周围神经缺损的实验研究

发布时间：2018-03-26 06:22

本文选题：自体静脉神经导管　切入点：周围神经再生　出处：《四川大学学报(医学版)》2017年05期

【摘要】：目的探索血管支架支撑的自体静脉神经导管对新西兰大白兔周围神经缺损再生修复作用。方法新西兰大白兔30只,随机分为自体神经组(A组)、自体静脉神经导管组(B组)、血管支架支撑后的自体静脉神经导管组(C组)3组。分离并切除大白兔左后肢腓总神经约10mm,制备腓总神经缺损,A组将切除的腓总神经旋转180°后缝合于缺损处,B、C组:分离切取20mm长的颈外静脉,静脉回缩修剪后,B组将取下的静脉桥接于神经缺损处,C组将血管支架置入获取的颈外静脉,再接于神经缺损处。术后观察兔足部溃疡情况,进行兔左足展趾反射评分,术后12周,进行神经缺损修复的大体观察及电生理检测,比较各组兔左、右侧后肢腓肠肌湿质量比,并对修复的神经组织进行形态学观察和透射电镜检测,分析各组神经再生及功能恢复情况。结果术后各组均发现兔手术侧足跟部溃疡,以B组最严重,A组最好。术后12周A组展趾反射评分恢复最快且最好,C组次之,B组最差,组间差异有统计学意义(P0.05)。电生理检测A组神经传导速度最快(64.01±5.61)m/s,C组次之(53.43±7.99)m/s,B组最差(29.15±4.45)m/s,各组之间差异有统计学意义(P0.05)。腓肠肌湿重比A组C组B组,组间差异有统计学意义(P0.05)。术后12周,A组再生神经形态正常,B组静脉导管坍陷,直径较小,C组自体血管支架支撑的静脉导管未塌陷,直径略大于A组。光镜及透射电镜观察发现再生神经束面积、纤维密集程度及髓鞘厚度均为A组和C组明显优于B组(P0.05)。结论血管支架支撑自体静脉神经导管能够较好的促进新西兰大白兔周围神经缺损的再生。
[Abstract]:Objective to explore the effect of autogenous vein nerve catheter supported by vascular stent on regeneration of peripheral nerve defect in New Zealand white rabbits. They were randomly divided into autogenous nerve group (group A), autologous vein nerve conduit group (group B) and group C (group C) after stent support. The common peroneal nerve of left hind limb of rabbits was separated and resected about 10 mm to prepare common peroneal nerve deficiency. In group A, the common peroneal nerve was rotated 180 掳and then sutured to the defect. The external jugular vein of 20mm was removed and removed. After vein retraction and pruning, the vein of group B was bridged to the nerve defect and the vascular stent was placed into the external jugular vein of the nerve defect in group C. after operation, the ulcer of the foot was observed and the reflex score of the left extended toe of the rabbit was evaluated. At 12 weeks after operation, gross observation and electrophysiological examination of nerve defect repair were carried out. The wet mass ratio of gastrocnemius muscle of left and right hind limbs was compared in each group. Morphological observation and transmission electron microscopy were performed on the repaired nerve tissue. Results the nerve regeneration and functional recovery of each group were analyzed. Results all the groups found that the ulcer of the heel was the most serious in group B, the most serious in group A was the best, the score of extended toe reflex was the fastest in group A 12 weeks after operation, and the worst was in group B, which was the best in group C and the worst in group B. There was significant difference between the two groups (P 0.05). Electrophysiological examination showed that the fastest nerve conduction velocity in group A was 64.01 卤5.61 m / s, followed by group C (53.43 卤7.99 m / s / s), and the lowest was 29.15 卤4.45 m / s / s in group B. The wet weight of gastrocnemius muscle in group A was significantly higher than that in group C (P 0.05). At 12 weeks after operation, the regenerated nerves of group A were normal and the venous ducts of group B were collapsing, but the venous ducts supported by autologous vascular stents in group C did not collapse. The diameter of group A was slightly larger than that of group A. the area of regenerated nerve bundle was observed by light microscope and transmission electron microscope. The density of fibers and the thickness of myelin sheath in group A and C were significantly better than those in group B. conclusion Autologous venous nerve catheter supported by vascular stent can promote the regeneration of peripheral nerve defect in New Zealand white rabbits.
【作者单位】：四川大学华西医院骨科;广安市人民医院骨科;
【基金】：四川省科技厅科技支撑计划项目(No.2013FZ0066) 四川省卫生和计生委员会普及应用项目(No.17PJ128) 广安市2016年创新基金项目资助
【分类号】：R745

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