中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (10): 1674-1677.doi: 10.4103/1673-5374.165321

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

肌肉填充血管的导管重建指神经:短期与长期再生效果

  

  • 收稿日期:2015-06-09 出版日期:2015-10-28 发布日期:2015-10-28

Comparison of short- with long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits

Jennifer Lynn Schiefer, Lukas Schulz, Rebekka Rath, Stéphane Stahl, Hans-Eberhard Schaller, Theodora Manoli*   

  1. Department of Hand, Plastic and Reconstructive Surgery with Burn Center, BG Trauma Center, University of Tuebingen, Schnarrenbergstr. 95, 72076 Tuebingen, Germany
  • Received:2015-06-09 Online:2015-10-28 Published:2015-10-28
  • Contact: Theodora Manoli, M.D.,theodora.manoli@gmail.com.

摘要:

周围神经损伤是常见的、常伴有组织损伤。如果原发性神经吻合术不适用,则需要桥接的办法修复周围神经缺损。我们对肌肉-静脉导管在重建指神经后短期和长期再生效果进行比较研究。我们分别在尺神经损伤后6-12个月和14-35个月采用静态和动态两种辨识方法和Semmes-Weinstein Monofilaments(SWM)来评估7例使用肌肉-静脉导管修复尺神经患者的感觉恢复情况。随访均在临床上的再生状态消失后进行。在7个病例中,有4例在两种2PDs评估下表现出了进一步的恢复情况,另1例仅在静态2PD短期和长期随访检查之间发现有1-3毫米的进展。此外,还有1例在两种2PDs评估中表现出后期恢复情况。4例在SWM检测下表现出感官改善。通过这项试验研究,尽管临床上的再生状态已经消失,但感觉恢复仍然存在。肌肉静脉导管应运而生。其在桥接周围的缺损方面显示出良好的前景。相较于自体神经移植。该导管有避免感觉缺失的优势,切能促进更多轴突再生,并产生良好的功能结局。

Abstract:

Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments.
This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.

Key words: peripheral nerve, regeneration, muscle-in-vein conduits, digital nerves, sensory recovery, Semmes-Weinstein, two-point discrimination, outcome, short-term, long-term