含神经生长因子的羊膜基质管桥接修复神经缺损的实验研究-外科学骨科专业论文.docxVIP

华中科技大学同济医学院 华中科技大学同济医学院 博士毕业论文 含神经生长因子的羊膜基质管桥接修复神经缺损 的实验研究 华中科技大学同济医学院附属同济医院 研究生：梁群 导师： 陈安民教授 摘 要 目的研究含神经生长因子(nerve growth factor，NGF)的人羊膜 基质(human ammion membrane matrix，HA删)微孔管(HA删+NGF)桥接 修复周围神经缺损的作用和效果。 方法将健康Wistar大鼠80只按治疗方法随机分为分为4组，每组 每时段8只，分别用含神经生长因子人羊膜基质微孔管(HA涮+NGF)、人羊 膜基质微孔管(HAMM)、神经生长因子(NGF)及生理盐水对照修复坐骨神经 1．0 cm缺损；术后4、8周和12周分别进行伤肢功能恢复测定、电生理学、 组织形态学检查、图像分析和透视电镜观察。 结果近端神经再生轴突生长通过1．5cm长的HAE*+NGF移植体，重新 支配终末骨骼肌，其再生神经纤维生长速度、数量明显快(多)于单纯HA涮 移植体和单纯的NGF组，术后12周时坐骨神经功能恢复良好。 结论HAMM和NGF联合使用可促进轴突再生及其髓鞘化，对损伤神经 及伤肢的功能恢复有明显协同促进作用，HAMM+NGF是一种很有希望的促进 周围神经再生的生物材料。 关键词 周围神经神经再生神经生长因子人羊膜基质 竺!型彗查堂旦塑垦兰堕———————————————j生兰兰些兰苎—一 竺!型彗查堂旦塑垦兰堕———————————————j生兰兰些兰苎—一 Experimetal studies of peripheal nerve regeneration through HAMM+NGF graft s in rat s Department of Orthopaedic Surgery,Tongjing Hospital，Tongji Medical College，Huazhong University of Science and Technology Postgratuate Candidate： LIANG Qun Supervisor：Prof．CHEN Anmin Abstact Objective To investigate the effect of peripheral nerve regeneration through HA删+NGF(human ammion membrane matrix and nerve growth factor)grafts． Methods 80 Wistar rats were randomly divided into four groups control group，+NGF group，HAMM group and HAYN+NGF group，wi th 8 rats in each and in each period of time．A 1．0 cm defect of the left sciatic nerve were made and then repaired randomly by different means． Histomorphometry examination was undertaken at 4，8 weeks postoperatively．At 8，12 weeks postoperation，the following items as functional assessments of end—organ reconnection， electrophysi。logy， image analyse and transmission electron microscope observation were determined Results At 12 weeks postoperation， Motor nerve conduction veloc ity of the nerve repaired with HAMM or NGF were lower than that 兰!型垫查兰堕堕堕堂堕 兰!型垫查兰堕堕堕堂堕 堡圭兰些堕塞——一 of the nerve repaired with heterograft of HAMM+NGF．At 12 weeks postoperation，HAMM+NGF condui t group showed more nerve fibers，bigger axon diameter and thicker meylin sheaths than other groupS． Conclu