【摘要】 目的:分析修复膜在大鼠腮腺切除术中对神经再生的屏蔽作用。方法:对40只雄性SD大鼠进行双侧腮腺部分切除术,左侧为实验侧,在腮腺表面置入修复膜;右侧为对照侧,直接将皮肤、皮下组织覆盖于腮腺表面。大鼠分为A、B 2组,每组20只,A组术中保护面神经,B组术中切断面神经颊支。在腮腺手术后1周、2周、4周、3个月、6个月,每组分别处死4只大鼠。在双侧腮腺咬肌区取材,进行HE染色及PGP9.5免疫组化染色,观察手术部位的愈合情况。采用SPSS13.0软件包对所有大鼠、A组、B组大鼠左、右侧表皮内神经纤维密度及真皮内神经纤维密度分别进行配对t检验。结果:置入修复膜的实验侧伤口愈合过程中,炎症细胞浸润多于对照侧。术后4周时,修复膜被自身组织替代。B组大鼠术后1周、2周、4周均可见神经瘤形成。B组大鼠左侧真皮内神经纤维密度小于右侧,差异具有显著性(P<0.05)。结论:修复膜可使切断面神经的大鼠真皮神经纤维数量减少,可在一定程度上阻止神经纤维的生长,初步揭示出腮腺表面置入修复膜对神经再生的屏障作用。更多还原

【Abstract】 PURPOSE: To evaluate the role of reparative membrane as a barrier in nerve regeneration during parotidectomy in rats.METHODS: The bilateral parotids of 40 male SD rats were resected partially.The left parotids of rats were used as experimental sides,in which reparative membranes were sutured on the surface of remaining parotids during parotidectomy;the right parotids were performed as control,in which the remaining parotids were covered with subcutaneous tissue and skin directly.The rats were divided into group A and B.Facial nerves were protected carefully in group A and the buccal branch of facial nerve was cut off in group B.4 rats were sacrificed in each group at 1 week,2-week,4-week,3-month and 6-month postoperatively.The tissue blocks in the bilateral parotid-masseter region were obtained to perform hematoxylin-eosin staining and PGP9.5 immunostaining.The healing process of operative regions was examined.Paired sample t test in SPSS 13.0 software package was used to compare the intraepidermal nerve fiber density and dermis nerve fiber density between the left and right sides in all rats,rats in group A and group B,respectively.RESULTS: The inflammation cells infiltrated more severely in the experimental sides than in the control sides during healing process.The reparative membranes were replaced by tissue at 4-week after surgery.Neuroma formation could be observed in group B at 1 week,2-week and 4-week after surgery.The dermis nerve fiber density of group B was less than that of group A,which had significant difference(P<0.05).CONCLUSIONS: By mimicking parotidectomy in rats,this study found that the inserted reparative membrane could reduce the dermis nerve fiber density of the rat whose facial nerve was cut off.The results showed that the reparative membrane could prevent nerve growing to a certain extent,and be used as a barrier in nerve regeneration.更多还原