中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (4): 706-712.doi: 10.4103/1673-5374.247475

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

两端不同内径生物套管小间隙套接缝合用于周围神经缺损的转位修复

  

  • 出版日期:2019-04-15 发布日期:2019-04-15
  • 基金资助:

    国家自然科学基金（31571236，31571235）; 中国国家重点研究发展计划（2016YFC1101604）; 中国国家重点基础研究计划（973计划）（2014CB542200）; 中国教育部创新计划RT_16R01; 北京科技新星交叉项目（2018019）

Repair of peripheral nerve defects by nerve transposition using small gap bio-sleeve suture with different inner diameters at both ends

Yu-Hui Kou 1 , You-Lai Yu 2 , Ya-Jun Zhang 1 , Na Han 1 , Xiao-Feng Yin 1 , Yu-Song Yuan 1 , Fei Yu 1 , Dian-Ying Zhang 1 , Pei-Xun Zhang 1 , Bao-Guo Jiang 1   

  1. 1 Peking University People’s Hospital, Beijing, China
    2 The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
  • Online:2019-04-15 Published:2019-04-15
  • Contact: Pei-Xun Zhang, MD, PhD, zhangpeixun@126.com; Bao-Guo Jiang, MD, PhD, jiangbaoguo@vip.sina.com.
  • Supported by:

    This research was continuously funded by the National Natural Science Foundation of China, No. 31571236, 31571235 (to YHK  and PXZ); the National Key Research and Development Program of China, No. 2016YFC1101604 (to DYZ); the National Key Basic Research Program of China (973 Program), No. 2014CB542200 (to BGJ); the Ministry of Education Innovation Program of China, No. IRT_16R01 (to BGJ); the Beijing Science and Technology New Star Cross Program of China, No. 2018019 (to PXZ).

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摘要：

周围神经转位修复过程中，若转位神经之间直径差距较大或需同时修复多个远端神经，传统外膜缝合存在缝合点处张力较大的问题，甚至可导致神经缝合的失败。因而，实验设计应用两端不同内径生物套管小间隙套接缝合技术，实现大鼠腓总神经近端转位方式修复2mm的胫神经缺损，并与传统神经外膜缝合进行比较。修复后3个月，通过胫神经功能指数、神经电生理测量、肌肉生物力学及湿重测量、神经锇酸染色和肌肉HE染色方法评估胫神经横断大鼠神经功能、以及神经再生和神经支配肌肉恢复情况。结果显示套接修复后胫神经局部无明显的炎症反应和神经瘤形成；生物套管套接缝合组胫神经传导速度、肌力、肌肉湿重、肌纤维横截面积、新生有髓神经纤维数量与神经外膜缝合组相近。证实两端不同内径生物套管小间隙套接缝合可实现不同直径神经之间的外科缝合，并能够促进损伤周围神经再生及功能恢复。

orcid: 0000-0001-8436-5266(Bao-Guo Jiang)

关键词: 生物套管, 小间隙, 套接缝合, 神经转位, 神经缺损, 神经导管, 神经再支配, 周围神经

Abstract:

During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining. There was no obvious inflammatory reaction and neuroma formation in the tibial nerve after repair by the small gap bio-sleeve suture with different inner diameters at both ends. The conduction velocity, muscle strength, wet muscle weight, cross-sectional area of muscle fibers, and the number of new myelinated nerve fibers in the bio-sleeve suture group were similar to those in the epineurial neurorrhaphy group. Our findings indicate that small gap bio-sleeve suture with different inner diameters at both ends can achieve surgical suture between nerves of different diameters and promote regeneration and functional recovery of injured peripheral nerves.

Key words: nerve regeneration, bio-sleeve, small gap, sleeve suture, nerve transposition, nerve defect, nerve conduit, nerve reinnervation, peripheral nerve, neural regeneration