【作者】 沈华； 沈尊理； 张佩华； 张俊锋； 贾万新； 张兆锋； 黄一雄；

【Author】 SHEN Hua SHEN Zun-li ZHANG Pei-hua,et al.Department of plastic surgery,Shanghai Jiao-Tong University affiliated first People’s Hospital.shanghai,P.R.China 200080.E-mail:samwells@sina.com.cn

【机构】 上海市第一人民医院整形科； 东华大学纺织学院；

【摘要】 目的探讨甲壳素涂层并预置引导纤维神经导管修复周围神经缺损的效果。方法成年雌性SD 大鼠24只,平均分成4组,无菌条件下切断双侧坐骨神经,制成14mm 的大鼠坐骨神经缺损模型。采用甲壳素涂层并预置引导纤维的聚乳酸和聚羟基乙酸的共聚物(PGLA)神经导管作为实验组A 组,分别以甲壳素涂层的PGLA 神经导管为B 组,单纯PGLA 神经导管为C 组,自体神经移植组为D 组作对照,每组6只。术后4周和12周后通过一般观察,肌电图检查,抗S-100免疫组织化学染色和组织学观察,图象分析评价修复的效果。结果术后4周A、B、C 组神经导管中有新生轴索通过,再生神经发育不成熟,术后12周各组再生神经已通过神经导管长入远端,肌电图,S-100染色和图像分析结果表明A组再生神经轴突数量及再生神经质量优于B、C 组(P<0.05)。结论甲壳素涂层并预置引导纤维的神经导管是能有效修复周围神经缺损。更多还原

【Abstract】 Objective To study the result of using nerve conduit coatedwith chitosan and filled with a guide-fiber to repair peripheral nervedefect.Methods Twenty-four female adult SD rats were made the model of14-mm gap on bilateral sciatic nerve under sterility condition,rats wererandomly divided into four groups(n=6),group A:polymerpolyglycolic-lactic acid(PGLA)nerve conduit coated with chitosan andfilled with a guide-fiber as experimental group to repair 14mm gap of ratsciatic nerves,group B:PGLA nerve conduit coated with chitosan,groupC:PGLA nerve conduit.group D:autograft.Group B、C、Dacted as control group.The repair result was evaluated by normal observation,EMG testing,S-100 histological immunostaining and biography analysis at 4 and 12 weeksafter operation.Result At 4 weeks,there were new regenerating immaturefibers in A、B、C conduit,at 12 weeks,the regenerating nerve fibres wereseen to have bridged the gap.The repair result of PGLA nerve conduit coatedwith a chitosan and filled with guide-fiber was better than those of B、C groups.Conclusion:PGLA nerve conduit coated with chitosan and filledwith a guide-fiber offers a possible substitute for repair of peripheralnerve defects.更多还原