纤维蛋白胶和医用OB胶联合几丁聚糖-胶原导管修复面神经损伤

背景：纤维蛋白胶和医用OB胶均能用于周围神经损伤的修复,但两种胶体的结构组成和作用原理完全不同。目的：对比分析纤维蛋白胶或医用OB胶联合几丁聚糖-胶原导管修复兔面神经损伤的效果。方法：制作中国大耳白兔右侧面神经下颊支损伤模型,随机数字表法分成3组：显微外科吻合组,将神经断端对位,作外膜原位吻合;纤维蛋白胶导管粘合组与医用OB胶导管粘合组分别采用纤维蛋白胶或医用OB胶粘合与显微外科技术吻合进行修复。术后16周进行大体观察、神经电生理检测、组织学观察、图像分析,评价神经再生恢复情况。结果与结论：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。3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）检测结果差异无显著性意义（P〉0.05）,再生轴突恢复比相似（P〉0.05）,但轴突再生率不同,纤维蛋白胶导管粘合组、医用OB胶导管粘合组均高于显微外科吻合组（P〈0.05或0.01）,其中医用OB胶导管粘合组最高。说明胶原导管生物相容性良好,与纤维蛋白胶或医用OB胶联合应用修复损伤神经效果肯定,但纤维蛋白胶更适于神经损伤的手术操作。

Fibrin glue or OB glue with chitosan-collagen conduit for repair of facial nerve injury

BACKGROUND：The fibrin glue or OB glue can be used in the repair of peripheral nerve damage,but their colloidal structure and underlying mechanism are entirely different.OBJECTIVE：To contrastively analyze the effect of fibrin glue or OB glue combined with chitosan-collagen conduit for repairing rabbit facial nerve damage.METHODS：Chinese rabbits were used to establish the injury model in right facial nerve of rabbits,which were divided into three groups randomly：microsurgery anastomosis group：the nerve stump contraposition and adventitia in situ anastomosis were performed;fibrin glue group and OB glue group were respectively treated with fibrin glue and OB glue based on microsurgery anastomosis.General observation,electrophysiological study,histological study and image analysis were performed at 16 weeks postoperatively.All results were used to evaluate the nerve regeneration.RESULTS AND CONCLUSION：The chitosan-collagen conduit was obviously degraded at 16 weeks postoperatively and they also restrained the formation of fibrous connective tissue around anastomotic stoma.The functional recovery of nerve muscles was good in three groups,the motor nerve action potential and the compound muscle action potential of orbicularis oris were analyzed,which showed no significant difference between them（P 0.05）.The recovery rate of regenerated axons of three groups had no significant difference（P 0.05）,but the axonal regeneration rate in the fibrin glue group and OB glue group was higher than in microsurgery anastomosis group（P 0.05 or 0.01）,reached a peak at OB glue group.Chitosan-collagen conduit have excellent biocompatibility,and combined with fibrin glue or OB glue certainly result in repairing injured nerves,but the fibrin glue is more suitable for operative nerve injury.