中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (6): 594-601.doi: 10.4103/1673-5374.130099

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

改良神经导管外形与粘合剂吻合技术修复损伤坐骨神经

  

  • 收稿日期:2014-02-22 出版日期:2014-03-22 发布日期:2014-03-22

Sciatic nerve repair using adhesive bonding and a modified conduit

Xiangdang Liang 1, Hongfei Cai 1, Yongyu Hao 2, Geng Sun 3, Yaoyao Song 1, Wen Chen 1   

  1. 1 Department of Orthopedics, General Hospital of Chinese PLA, Beijing, China
    2 Wei Zikeng Clinic of General Armament Department of Chinese PLA, Beijing, China
    3 Department of Orthopedics, 252 Hospital of Chinese PLA, Hebei Province, China
  • Received:2014-02-22 Online:2014-03-22 Published:2014-03-22
  • Contact: Xiangdang Liang, M.D., Department of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, China, lxd301@263.net.

摘要:

以往修复周围神经损伤直接将粘合剂滴到神经断端,该方法不利于神经断端固定且粘合剂易侵入断端,而圆柱形神经导管也不方便操作,从而影响修复效果。鉴于此,实验建立坐骨神经全横断损伤大鼠模型,选用一种改进的神经导管,长1 cm,内径1.5 mm,导管表面有2条处于同一直线但不连续的裂缝。分别采用粘合剂-2-辛基-氰基丙烯酸酯和缝合线2种方法配合此神经导管修复坐骨神经。结果发现,在采用同样的神经导管进行操作的条件下,粘合剂吻合法的平均吻合时间短于缝合线吻合法,但2种方法所检测的大鼠坐骨神经指数、动作诱导电位潜伏期及振幅、肌肉恢复率、吻合口远端有髓鞘神经纤维数量、轴突直径及髓鞘厚度均差异无显著性意义。结果证实,应用粘合剂吻合技术及改进的神经导管修复周围神经有效可行,大幅缩短吻合时间,达到了与经典缝合法相同的修复效果。

关键词: 神经再生, 周围神经损伤, 神经修复, 粘合剂吻合, 氰基丙烯酸酯, 神经导管, 缝合吻合, 坐骨神经, 导管内径, 电生理, 肌肉恢复, 组织学

Abstract:

When repairing nerves with adhesives, most researchers place glue directly on the nerve stumps, but this method does not fix the nerve ends well and allows glue to easily invade the nerve ends. In this study, we established a rat model of completely transected sciatic nerve injury and repaired it using a modified 1 cm-length conduit with inner diameter of 1.5 mm. Each end of the cylindrical conduit contains a short linear channel, while the enclosed central tube protects the nerve ends well. Nerves were repaired with 2-octyl-cyanoacrylate and suture, which complement the function of the modified conduit. The results demonstrated that for the same conduit, the average operation time using the adhesive method was much shorter than with the suture method. No significant differences were found between the two groups in sciatic function index, motor evoked potential latency, motor evoked potential amplitude, muscular recovery rate, number of medullated nerve fibers, axon diameter, or medullary sheath thickness. Thus, the adhesive method for repairing nerves using a modified conduit is feasible and effective, and reduces the operation time while providing an equivalent repair effect.

Key words: nerve regeneration, nerve repair, adhesive anastomosis, cyanoacrylate, nerve conduits, sciatic nerve, electrophysiology, muscle recovery, the International Technology Cooperation Program, neural regeneration