局部应用明胶海绵浸润鼠神经生长因子治疗周围神经损伤

发布时间：2018-08-04 15:40

【摘要】：背景:有研究尝试将外源性鼠神经生长因子用于周围神经损伤局部,发现局部注射鼠神经生长因子能有效促进损伤神经修复,且局部应用效果优于全身应用。目的:评价明胶海绵浸润鼠神经生长因子用于治疗周围神经损伤的临床疗效。方法:纳入单一、完全断裂周围神经损伤患者36例,其中男16例,女20例,年龄18-48岁,采用随机数字表法均分为2组,实验组急诊行清创、神经端端直接吻合,术中将浸润鼠神经生长因子的明胶海绵环绕包裹于神经吻合处;对照组急诊行清创、神经端端直接吻合,吻合神经处不予特殊处理。两组术后常规石膏固定,抗炎、营养神经、改善循环治疗。治疗后4周进行电生理检查,治疗后6个月进行神经损伤远端感觉、运动功能评价。结果与结论:实验组感觉电位恢复14例,恢复率为78%;运动电位恢复15例,恢复率为83%。对照组感觉电位恢复10例,恢复率为57%;运动电位恢复12例,恢复率为66%。两组间感觉、运动电位恢复率比较差异有显著性意义(P0.05)。实验组17例神经功能得到不同程度恢复,总有效率为94%;对照组15例神经功能得到不同程度恢复,总有效率为83%,两组间总有效率比较差异有显著性意义(P0.05)。表明局部应用明胶海绵浸润鼠神经生长因子可有效促进周围神经损伤的修复,且具有良好的生物相容性。
[Abstract]:Background: some studies have attempted to apply exogenous nerve growth factor (NGF) to local peripheral nerve injury. It was found that local injection of NGF could effectively promote the repair of injured nerve, and the effect of local application was better than that of systemic application. Objective: to evaluate the clinical effect of gelfoam infiltrating nerve growth factor (NGF) on peripheral nerve injury in rats. Methods: a total of 36 patients (16 males and 20 females, aged 18-48 years) with complete peripheral nerve injury were divided into two groups by random digital table. The experimental group was treated with debridement and the nerve terminals were anastomosed directly. During the operation, the gelatin sponge of the infiltrating nerve growth factor was wrapped around the nerve anastomosis; in the control group, the emergency debridement was performed, the nerve end-to-end anastomosis was directly anastomosed, and no special treatment was given in the nerve anastomosis. Routine plaster fixation, anti-inflammatory, nutritional nerve and circulatory therapy were used in both groups. Electrophysiologic examination was performed 4 weeks after treatment, and distal sensory and motor function were evaluated 6 months after treatment. Results and conclusion: in the experimental group, the sensory potential recovered in 14 cases, and the recovery rate was 780.The recovery rate of motor potential was 833% in 15 cases. In the control group, the sensory potential recovered in 10 cases, the recovery rate was 57 and the motor potential recovered in 12 cases, the recovery rate was 66. There was significant difference in the recovery rate of motor potential between the two groups (P0.05). In the experimental group, 17 cases of nerve function recovered to different degrees, the total effective rate was 945.The control group 15 cases got different degrees of recovery, the total effective rate was 833%, there was significant difference in the total effective rate between the two groups (P0.05). The results showed that the application of gelatin sponge infiltrating nerve growth factor could effectively promote the repair of peripheral nerve injury and had good biocompatibility.
【作者单位】：天津医科大学第二医院骨科;
【分类号】：R318.08

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