翻转静脉双桥接兔面神经缺损的实验研究

目的:探讨利用双桥接技术和翻转静脉再生室修复兔面神经缺损的可行性。方法:将实验用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)、导管双桥接组(Ⅱ组)、翻转静脉双桥接组(Ⅲ组)。手术制作兔右侧面神经下颊支损伤模型,分别采用双桥接技术和原位神经吻合进行修复。术后16周进行大体观察、神经电生理检测、组织学观察、图象分析,以评价神经再生恢复情况。结果:16周时几丁聚糖—胶原再生室吸收明显且无异物反应,IOVG基本完全吸收形成类神经外膜样结构。3个组的神经传导速度(NCV)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显著性差异。图象分析结果提示3个组轴突再生率相同,再生轴突成熟度Ⅰ组与Ⅲ组均高于Ⅱ组而且差异有统计学意义(P<0.05)。结论:利用翻转静脉和双桥接技术联合修复周围神经缺损方法简单、效果肯定。

The Experimental Study of Double-bridging Facial Nerve Defect in Rabbits by Inside-out Vein Grafts

Objective: To evaluate the feasibility of repairing the defects in rabbits by double-bridging technique and inside-out vein graft.Methods: Thirty chinese rabbits were divided into three groups randomly.15 mm defects in right facial nerve of rabbits were repaired in three groups: nerve autografts(groupⅠ),double-bridging with chitosan-collagen conduit(groupⅡ),and double-bridging with inside-out vein graft(groupⅢ).General observation,electrophysiological study,histological study and image analysis were performed 16 weeks postoperatively.All results were used to evaluate the nerve regeneration.Results: Chitosan-collagen chambers were obviously degraded 16 weeks postoperatively and there was no foreign body reaction at this stage.The nerve conduction velocity(NCV)and compound muscle action potentia(CMAP)of regenerated nerve were analyzed,which showed that there was no significant difference in the three groups.There was no significant difference in the rate of regeneration of myelinated axon of the three groups.The maturity degree of myelinated axon of the three groups was different(P<0.05),which is higher in groupⅠ and group Ⅲ than in group Ⅱ(P﹤0.05).Conclusion: Bridging a defect in peripheral nerve with inside-out vein graft and double-bridging chambers is a simple and effective method.