FK506局部缓释膜片促进周围神经再生的临床应用研究

目的临床观察在神经缝合口周围置入FK506高分子缓释膜片后对神经再生的影响。方法?选取同一时间段(4个月内)，在腕横纹至肘上5cm处因切割伤而导致正中神经或尺神经断伤的急诊病例16例。结合病人是否接受FK506治疗的意愿分为实验组及对照组，每组8例。实验组用9-0无创尼龙缝线将神经两断端作端端缝合，并将含有20mg FK506的高分子可生物降解膜片环绕神经缝合口一圈后用筋膜等软组织覆盖修复的神经和膜片。将膜片制成以1mg／d的速度释放，共20d。对照组仅用同法修复神经。结果术后1周起随访至2年。实验组在术后14周肌电图检测即有新生电位出现，较对照组提前4周。术后3～12个月测定，实验组感觉神经再生速度平均为3．1mm／d，明显快于对照组的1．7mm／d。实验组远期功能恢复的优良率也优于对照组。结论从FK506的药理作用和应用结果分析，FK506具有针对性促进周围神经再生的作用。

Promotion of peripheral nerve regeneration through local slow-releasing diaphragm with FK506:a clinical application study

Objective To observe the effect of implantation of slow-releasing diaphragm with FK506 around the nerve anastomosis on the peripheral nerve regeneration. Methods The study was within the same 4 months. There were 16 cases with acute median or ulnar nerve cut injury from wrist transverse brace up to 5cm proximal to elbow joint. They were divided into experiment and control groups randomly whether the patient was willing to receive the treatment of FK506, with 8 in each. In experimental group, anastomosis was done in end-to-end way by 9-0 non-atraumatic suture, which was wrapped by biodegraded diaphragm with FK506 for 20mg (releasing rate 1mg/day). Then the repaired nerve and the diaphragm were covered by local fascia. In control group, only nerve repair was done. Results The follow-up was ranged from 1 week to 2 years after the operation. In experimental group, there was regenerated potential on 14 weeks after operation, which was 4 weeks earlier than that in control group. The regeneration rate in sensation recovery averaged 3.1mm/d, which was faster than that in the control group (1.7 mm/d). The excellent and good rate in late function recovery in experimental group was superior to that in control group. Conclusion FK506 can promote peripheral nerve regeneration.