小间隙吻合术结合控释生长因子促进大鼠坐骨神经再生实验研究

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1、摘要目的：探讨小间隙吻合术结合控释生长因子对大鼠坐骨神经损伤的修复作用。方法：SD大鼠27只随机分为A、B、C三组，每组9只。建立大鼠坐骨神经横断模型；A组：以含有神经生长因子(NGF)与碱性成纤维生长因子(bFGF)凝胶的硅胶管桥接神经远近端(间隙3mm)；B组：以含有生理盐水的硅胶管桥接神经远近端(间隙3mm)：C组：采用神经远近端直接缝合。术后8周进行坐骨神经指数(SFI)、神经电生理、肌肉湿重比检查以及组织学和免疫组化观察。结果：从数据上看，A组在SFI、神经传导速度、肌肉湿重比、再生神经纤维密度及髓鞘化等方面均高于B组和C组，但三组的SFI、肌肉湿重比及新生轴突直径和髓鞘

2、厚度均无显著性差异(PPO．05)。A组与B组的神经传导速度差异无统计学意义(跚．05)，两组均明显高于C组(PCO．05)。至于再生神经纤维密度，三组间差异具有统计学意义(PcO．05)。结论：小间隙导管吻合法可为大鼠坐骨神经再生提供一个良好的微环境，小间隙吻合结合控释生长因子对神经再生有明显的促进作用。关键词：神经损伤；吻合；生长因子；坐骨神经；大鼠ControlreleaseofgrowthfactorscombinedwithsmallgapanastomosispromotessciaticnerveregenerationaftertransactioninratsAb

3、stractOi址．ctive；，Thenerveregenerationafterperipheralnerveinjuryisslowandthedegreeoffunctionalrecoveryislimitedfollowedbyahigherdisabilityrate．Howtoacceleratetherateofnerveregenerationandimprovethedegreeofnerverepairisaclinicalchallenge．Thisstudyaimedtoinvestigatetheroleandthemechanismofgrowthf

4、actorsgelcombinedwithsmallgapnerveanastomosisintheregenerationofsciaticnerveinjuryinratsbynervegrowthfactor(NGF)andbasicfibroblastgrowthfactor(bFGF)gelinjectingintosiliconchamberwhichbridgedthetransectionofnerve．Methods：AtotaloftwentysevenSDratswerechosenrandomly，withasharpbladetocutofftherigh

5、thindlegsciaticnerve．GroupAwithsilicontubecontainingNGFandbFGFgeltobridgethenerveproximalanddistalends(gap3ram)，GroupBwithsilicontubecontainingsalinetobridgethenerveproximalanddistalends(gap3ram)，GroupCwiththedirectsutureofthenerveproximalanddistalends．Eightweeksaftersurgery，thesciaticnervefun

6、ctionindex；neuralelectrophysiologyjmusclewetweightandhistological，immunohistochemicalwereobserved．Results：Thesciaticnervefunctionindex，nerveconductionvelocityandmusclewetweight，thedensityofnervefiberregeneration，myelinizationingroupAwerebetterthanthoseingroupBandCConclusion：Smallgapnerveanasto

7、mosismethodCanprovideagoodregenerationmicroenvironmentfortheratsciaticnerveregeneration，andthecombinedstrategyofgrowthfactorgelwithsmallgapnerveanastomosisappearstohavemorepositiveeffectonnerverepair．Keywords：Nerveanastomosis；Sciaticner