自体雪旺细胞促周围神经端侧吻合轴突侧支发芽的实验研究

目的：研究周围神经损伤行端侧吻合口自体雪旺细胞（Sc)移植对端侧吻合的作用，探讨改善端铁合质量的方法。方法：72只Wistar大鼠随机平均分为3组：A组，左腓神经端端吻合组；B组，左胫腓神经端侧吻合组；C组，左胫腓神经端侧吻合后再生小室内注自体雪旺细胞悬液组。于术后2、4、6个月每组分别取8只大鼠取材、检测，依次行大体观察、神经电生理检测、肌湿重、组织学及电镜观察等。结果：C组与B组各项指标比较：肌力、肌纤维截面积、有髓纤维截面积差异有显著性（P＜0．05）。神经电生理、肌湿重、有髓纤维数目差异有非常显著性（P＜0．01），显示恢复较好，某些指标（神经电生理、肌湿重、肌纤维截面积）在6个月时接近A组（P＞0．05）。结论：自体雪旺细胞移植可以促进周围神经端侧吻合轴突侧支发芽，改善端侧吻合口质量。

An experimental study of Schwann cell autografting promoting axonal collateral sprouting after peripheral nerve end-to-side anastomosis

Objective To explore the effect of Schwann cell autografting on peripheral nerve end-to-side anastomosis and find a way to improve the quality of it. Methods 72 Wistar rats were randomly divided into three groups: In group A, the left peroneal nerve was anastomosed end-to-end after transected; In group B, the distal end of peroneal nerve was anastomosed end-to-side with the normal tibial nerve trunk after the peroneal nerve was transected; In group C, the distal peroneal nerve was bridged with sili-cone tube after tibio-peroneal nerve end-to-side anastomosis and suspension of Schwann cell were injected into silicone chamber. In each group, 8 rats were taken out for electro-physiological, histological and ultra-structural measurement at 2nd, 4th and 6th month after operation. Results Each measurement index of group C demonstrated better innervation of target tissue. There were significant differences in the indexes between group B and C ( P <0.05 or P <0.01).Conclusion Autografting of Schwann cell can promote the collateral sprouting of peripheral nerve end-to-side anastomosis, suggesting that autografting of Schwann cell can improve the quality of end-to-side anastomosis.