纤维蛋白胶联合几丁聚糖-胶原导管修复兔面神经损伤的效果

doi:10.3969/j.issn.1005-4979.2012.03.005

摘要/Abstract

摘要： 目的：探讨纤维蛋白胶联合几丁聚糖-胶原导管修复兔面神经损伤的效果。方法：30只健康中国大耳白兔随机分成3组，分别为显微外科吻合组（Ⅰ组）、纤维蛋白胶粘合组（Ⅱ组）、纤维蛋白胶联合几丁聚糖-胶原导管粘合组（Ⅲ组）。手术制作兔右侧面神经下颊支损伤模型，分别采用显微外科吻合、纤维蛋白胶粘合以及在几丁聚糖-胶原导管内用纤维蛋白胶粘合技术进行修复。术后16周进行大体观察、神经电生理检测、组织学观察、图像分析，采用SPSS 17.0统计软件对各组数据进行方差分析（one way ANOVA）,以评价神经再生恢复情况。结果：16周时肉眼观察3组吻合口处均见神经再生。几丁聚糖-胶原导管吸收明显，能抑制吻合口周围纤维结缔组织形成。Ⅰ组再生神经周围软组织粘连较Ⅱ组和Ⅲ组严重；3个组神经肌肉功能恢复良好，口轮匝肌动作电位潜伏期和复合神经肌肉动作电位振幅(M波)检测结果经统计学分析无统计学意义（P>0.05）；组织学观察3组均可见不同程度纤维结缔组织和新生毛细血管增生及炎性细胞浸润，无论是HE低倍镜还是Gomori银染高倍镜观察，纤维蛋白胶和几丁聚糖-胶原导管作用明显；图像分析结果提示3组轴突再生率不同（P<0.05），Ⅱ组、Ⅲ组均高于Ⅰ组，其中Ⅱ组明显高于Ⅰ组且差异有统计学意义（P<0.01）；3个组再生轴突恢复比相似（P>0.05）。结论：几丁聚糖-胶原导管生物相容性良好，与纤维蛋白胶联合应用修复兔面神经损伤操作简便、效果肯定。

关键词: 纤维蛋白胶, 几丁聚糖-胶原导管, 周围神经, 神经再生, 兔

Abstract: Objective: This study was designed to assess the regeneration outcome of fibrin glue with chitosan-collagen conduit in peripheral nerve repair. Methods: Thirty Chinese rabbits were used in this study and their right facial nerves were traumatized. Rabbits were randomly divided into 3 groups: group Ⅰ, nerve repaired by autografts, group Ⅱ, nerve repaired by fibrin glue , and group Ⅲ, fibrin glue with chitosan-collagen conduit were applied. At the end of 16 weeks after operation, gross examination of the animals, electrophysiological studies, histological studies , and image analysis were performed. Database and calculations were analyzed using analysis of variance (one-way ANOVA) with the SPSS 17.0. Results: The nerve regenerated uneventful at 16 weeks after postoperation. Chitosan-collagen conduit was seemingly degraded and restrained the formation of fibrosis. Adherence of repaired nerve with surrounding soft tissue were found more severe in group Ⅰ than other two groups. The potential motor nerve action and the compound muscle action potential (CMAP) of regenerated nerve showed no significant difference between three groups (P>0.05). Histological study revealed various degree of fibrous hyperplasia and inflammatory reaction in the regenerative site. Fibrin glue and chitosan - collagen conduit induced effective regeneration manifested not only in low magnification of HE sections but also in high magnification of Gomori silver stain. The cross rate of myelinated fiber cross section diameter of the three groups showed differences (P<0.05), which was higher in group Ⅱ and group Ⅲ than in group Ⅰ (P<0.05). There was also significant difference between group Ⅱ and group Ⅰ(P<0.01). The recovery rate of myelinated fiber cross section diameter of the three groups showed no significant difference（P>0.05）. Conclusion: Chitosan-collagen conduit possesses excellent biocompatibility, fibrin glue may effectively regenerate peripheral nerve.

Key words: fibrin glue；chitosan-collagen conduit, peripheral nerves；nerve regeneration； rabbit

中图分类号:

R745.12

屈振宇,曲卫国,马卫东, 陈洪涛,曲晓娟,张璐. 纤维蛋白胶联合几丁聚糖-胶原导管修复兔面神经损伤的效果[J]. 《口腔颌面外科杂志》, 2012, 22(3): 174-178.

QU Zhen-yu, QU Wei-guo, MA Wei-dong , CHEN Hong-tao, QU Xiao-juan ,ZHANG Lu. Assessment of Regeneration in Peripheral Nerve Repair using Fibrin Glue with Chitosan-collagen Conduit in a Rabbit Model[J]. 《Journal of Oral and Maxillofacial Surgery》, 2012, 22(3): 174-178.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2012/V22/I3/174

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