提高周围神经移植修复脊髓损伤能力的实验研究

目的：探讨不同条件下周围神经移植修复脊髓损伤的能力。方法：以210只Wistar大白鼠从以下5个方面进行研究：（1）周围神经移植后肌肉源22、35kD神经营养因子（MNTF）的作用；（2）带血管周围神经移植；（3）二步吻合法技术的应用；（4）高压氧（HBO）和脉冲电磁场（PEMF）的作用；（5）带血管周围神经（VPN）与胚胎脊髓联合移植。观察指标为组织学、组织形态计量和电生理检测。结果：本实验动物存活率为62.38％。带血管周围神经与胚胎脊髓联合移植组再生轴突数目、质量及SEP恢复均优于其它组。结论：（1）在Wistar成鼠可成功建立带血管周围神经移植修复脊髓损伤的模型。（2）手术方法如带血供的周围神经和二步吻合技术，物理治疗如HBO和PEMF，以及生物化学方法如MNTF的应用等，虽然能提高损伤脊髓的再生能力，但其作用微弱，无功能性恢复。（3）带血管周围神经与胚修复脊髓损伤，对移植神经再生和胚胎脊髓的分化表现出相互促进、相互增强的作用，预示这种联合移植具有较好的前景。

Experimental study of the therapeutic effect of peripheral nerve graft to repair spinal cord injury

Objective To observe the effects of peripheral nerve graft to repair spinal cord injury (SCI) in different conditions.?Methods A total of 210 adult Wistar rats were used in this study, after SCI the cord defect were repaired by 5 mthodes:?(1)?free peripheral nerve graft (Group FPN) and using 22?35kD muscular neurotrophic factor (Group MNTF),(2)?Vascularized peripheral nerve graft (Group VPN),(3)?Two step nerve anastomosis (Group TSA),(4)?The use of hyperbaric oxygen (Group HBO) and pulsed electromagnetic fields (Group PEMF),(5)?Vascularized peripheral nerve and fetal spinal cord co graft (Group V+F).?Eight weeks after surgery,the ability of repair was assessed by histological analysis and potential studies.?Results The persistence was 62.38 percent in this study, Group V+F excell control groups in histological and potential.?Conclusion (1)?Experimental model of combined vascularized peripheral nerve autograft and fetal spinal cord allograf was created successfully.(2)?The use of VPN grafting,two step anastomosis,HBO,PEMF,MNTF et al only have slight effect in promoting the axons regeneration.(3)?The combination of VPN FSC could support the regeneration of central injured axons to certain degrees.