复合导管修复大鼠坐骨神经缺损的实验研究_临床医学论文.docVIP

复合导管修复大鼠坐骨神经缺损的实验研究_临床医学论文 复合导管修复大鼠坐骨神经缺损的实验研究_临床医学论文 【摘要】 目的 翻转静脉为内层、壳聚糖导管为外层组成复合神经导管，透明质酸钠凝胶为细胞外基质并加入神经生长因子，构成新型组织工程化人工神经，桥接大鼠坐骨神经缺损，观察其对神经再生的作用。方法 取24 只成年雄性SD大鼠随机分为4 组，建立大鼠坐骨神经缺损10 mm的动物模型，分别用复合导管(翻转静脉与壳聚糖)加神经生长因子，翻转静脉加神经生长因子，壳聚糖导管加神经生长因子和自体神经修复大鼠右后肢坐骨神经约10 mm的缺损。术后12 w进行形态学(光镜、透射电镜、免疫组织化学、轴突图像分析)和神经电生理学(运动神经传导速度、复合肌肉动作电位)检测。结果 纳入大鼠 24 只，均进入结果分析。①术后12 w时，对于各项形态学指标，A组与D组接近，差异无统计学意义;但A组优于B组、C组，差异有统计学意义(0.05)。②电生理指标：术后12 w时，A组坐骨神经平均传导速度明显高于B组、C组，但低于D组，差异有统计学意义(0.05)。A组平均动作电位幅度与自体神经移植组接近，优于B组、C组，差异有统计学意义(0.05)。③术后12 w时，A组腓肠肌湿重恢复率接近于D组，明显优于B组、C组，差异有统计学意义(0.05)。结论 以翻转静脉为内层、壳聚糖导管为外层组成复合神经导管，透明质酸钠凝胶为细胞外基质并加入神经生长因子，构成新型组织工程化人工神经，为神经缺损修复创造良好微环境，可明显促进神经再生。 【关键词】 复合导管;翻转静脉;壳聚糖导管;神经缺损 　　Abstract： Objective This experimental study is to construct the tissue-engineered artificial nerve mixed with composite conduit， sodium hyaluronate gel matrix and NGF， and evaluate the effectiveness for bridging rat sciatic nerve defect.Methods By establishing 24 models of 10 mm sciatic nerve defect， randomly divided into four groups. The sciatic nerve defects were repaired by tissue-engineered artificial nerve or autogenous nerve. In Group A， NGF was mixed with sodium hyaluronate gel matrix and composite conduit for nerve defect，in group B， NGF was mixed with sodium hyaluronate gel matrix and inside-out vein graft for nerve defect，in group C， NGF was mixed with sodium hyaluronate gel matrix and chitosan conduit for nerve defect，in group D， autograft. After 12 weeks， the regenerating nerve was checked by morphology (light microscope， transmission electron microscope (TEM)， immunohistochemistry， axon image-analysis) and electrophysiology (mean conduct velocity and action potential of sciatic nerve).Results All the 24 rats were involved in the result analysis. (1) In the twelfth week， as for morphology， each index of the group A was not different from the autograft group and better than the group B and C. (2) In the twelfth week，as for the results of electrophysiology， the mean conductive veloc