浅论复合导管修复大鼠坐骨神经缺损的实验研究.docx

浅论复合导管修复大鼠坐骨神经缺损的实验研究【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10mm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10mm的缺损。术后12w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12w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()。②电生理指标：术后12w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()。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()。③术后12w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()。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：ObjectiveThisexperimentalstudyistoconstructthetissue-engineeredartificialnervemixedwithcompositeconduit，sodiumhyaluronategelmatrixandNGF，andevaluatetheeffectivenessforbridgingratsciaticnerveByestablishing24modelsof10mmsciaticnervedefect，randomlydividedintofourgroups.Thesciaticnervedefectswererepairedbytissue-engineeredartificialnerveorautogenousnerve.InGroupA，NGFwasmixedwithsodiumhyaluronategelmatrixandcompositeconduitfornervedefect，ingroupB，NGFwasmixedwithsodiumhyaluronategelmatrixandinside-outveingraftfornervedefect，ingroupC，NGFwasmixedwithsodiumhyaluronategelmatrixandchitosanconduitfornervedefect，ingroupD，autograft.After12weeks，theregeneratingnervewascheckedbymorphology(lightmicroscope，transmissionelectronmicroscope(TEM)，immunohistochemistry，axonimage-analysis)andelectrophysiology(meanconductvelocityandactionpotentialofsciaticnerve).ResultsAllthe24ratswereinvolvedintheresultanalysis.(1)Inthetwelfthweek，asformorphology，eachindexofthegroupAwasnotdifferentfromtheautograftgroupandbetterthanthegroupBandC.(2)Inthetwelfthweek，asfortheresultsofelectrophysiology，themeanconductivevelocityofsciaticnerveinthegroupAwasfasterthanthatofgroupBandC，butlowerthanthatofthegroupactionpotentialamplitudeofgroupAwasnearlyequaltothatofgroupDandsignificantlyhigherthanthatofgroupBandC.(3)Inthetwelfthweek，themeangreen-weight(wetweight)percentageinthegroupAwasnearlyequaltothato