周围神经损伤修复及功能恢复评价 |
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引用本文: | 吕荣.周围神经损伤修复及功能恢复评价[J].中国临床康复,2011(8):1454-1458. |
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作者姓名: | 吕荣 |
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作者单位: | 苏州大学体育学院,江苏省苏州市215021 |
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摘 要: | 目的:评价修复周围神经缺损的各种生物型人工材料的性能、应用以及功能恢复评定方法,寻找适宜的周围神经替代物。方法:以"神经导管,周围神经损伤修复,生物材料,许旺细胞"为关键词,采用计算机检索2004-01/2010-11相关文章。纳入与生物材料以及组织工程神经相关的文章;排除重复研究或Meta分析类文章。以28篇文献为主,重点讨论周围神经修复生物型人工材料的种类、性能以及适宜的功能恢复评定方法。结果:以脱细胞神经基质以及人工合成可降解材料为主体的复合型生物工程材料可作为较理想的支架材料应用于周围神经组织工程。脱细胞神经支架解决了自体神经来源受限、移植物排斥反应等问题,韧性与可塑性接近自体神经,微环境更利于周围神经再生。人工合成可降解材料具有生物降解、可塑性、一定的通透性等优势,且已有商品化成品出现。若将上述材料分别合理构建复合材料,有可能得到性能良好的组织工程神经移植物。周围神经修复后功能恢复评定方法主要以大体与形态学观察、组织学、神经肌肉机能学评定为主,辅以分子生物学技术。各类评定方法的应用有利于筛选出最适宜的周围神经损伤修复材料与构建方案。结论:周围神经损伤修复生物型人工材料研究发展迅速,但仍没有超越自体神经移植的支架材料。脱细胞神经基质以及人工合成可降解材料复合构建支架可作为较好的周围神经支架,但仍需要与种子细胞、神经营养因子等联合构建,以取得良好的促进再生效果。当前,对周围神经损伤修复效果的评定更加注重于神经肌肉功能的恢复,迫切需要筛选出最佳的修复材料以及构建方案以满足组织工程神经移植以及功能康复的要求,达到对周围神经损伤后形态、结构修复与功能重建的目的。
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关 键 词: | 神经组织工程 周围神经 功能恢复 生物型人工材料 神经移植物 |
Peripheral nerve injury repair and functional recovery |
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Institution: | Lü Rong Institute of Physical Education,Soochow University,Suzhou 215021,Jiangsu Province,China |
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Abstract: | OBJECTIVE:To evaluate the properties,application and evaluation method of functional recovery in the repair of peripheral nerve defects using various biological artificial materials,and to search a suitable alternative to peripheral nerves.METHODS:Using "nerve conduit,peripheral nerve repair,biomaterials,Schwann cells" in Chinese as key words,a computer retrieval for articles from January 2004 to November 2010 was performed.Literatures about tissue engineering nerve and biomaterials were included;repeat study or Meta analysis articles were excluded.A total of 59 papers mainly focus the type,performance,and appropriate evaluation method of functional recovery of biological artificial materials on the restoration of peripheral nerve.RESULTS:The acellular nerve matrix and the composite biological engineered materials based on synthetic degradable materials as the main body,can be used as ideal scaffold materials for peripheral nerve tissue engineering.Acellular nerve scaffolds solve limited source of autologous nerve,graft rejection and other problems,its toughness and plasticity are close to autologous nerve,its micro-environment is more conducive to peripheral nerve regeneration.Synthetic biodegradable materials have biodegradability,plasticity,permeability and other advantages,and the commercialized products have emerged.If such materials were used to structure the complex materials,it is likely possible to obtain tissue engineered nerve graft with good performance.Functional recovery after peripheral nerve repair is mainly assessed by general and morphology,histological observations,neuromuscular function assessment,as well as molecular biology techniques.The application of various evaluation methods is conducive to screen out the repair materials and construction programs of peripheral nerve injury.CONCLUSION:The biological artificial materials in the restoration of peripheral nerve injury are rapidly developing,but still need a scaffold of autologous nerve graft.Acellular nerve matrix and composite materials of synthetic biodegradable scaffolds can be used as good scaffold for peripheral nerve,but still need the joint construction with seed cells and neurotrophic factors,in order to achieve good results in promoting regeneration.At present,the effect of repairing peripheral nerve injury is chiefly evaluated by the assessment of neuromuscular function recovery,it is an urgent need to find optimal repair materials and optimal construction scheme to meet tissue engineering neural transplantation and functional rehabilitation requirements,thus achieving repair of morphology,structure and functional reconstruction following peripheral nerve injury. |
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