自体富血小板血浆修复面神经损伤

背景：周围性面神经损伤治疗包括手术、理疗及药物等方法，但有些情况下治疗效果并不十分理想。目的：研究自体富血小板血浆在面神经损伤修复中的作用。方法：将健康大耳白兔10只双侧面神经上颊支横断后置入硅胶神经再生导管，一侧注入富血小板血浆为实验侧，另一侧注入生理盐水为对照侧。术后8周进行面神经大体观察、神经电生理检测、组织学观察、图像分析、评价面神经再生恢复情况。结果与结论：实验侧口轮匝肌动作电位潜伏期明显低于对照侧，复合神经肌肉动作电位振幅（M波）明显高于对照例（p〈0．01）。实验侧再生神经更显成熟，再生轴突较多，髓鞘分化较好，髓鞘厚度较均匀，再生轴突的直径接近正常，神经轴突较密集，排列较规则，神经纤维外膜较较对照组增厚，胶原纤维、弹力纤维层较对照组增多；对照侧再生轴突数目较少，分布不均匀，轴突发育较差，并见大量纤维结缔组织，空泡变性较实验侧为多。实验侧再生神经在有髓轴突直径、面积、髓鞘厚度及轴突计数等方面均明显优于对照侧，两组差异有显著性（P〈0．01）。提示富血小板血浆在面神经损伤修复再生中具有促进作用。

Autologous platelet rich plasma repair facial nerve injury

METHODS： The bilateral destroyed buccal nerve branches of the 10 white rabbits were put in silica gel nerve regeneration chamber, one side injected with platelet rich plasma as experimental group, the other side injected with normal saline as control group. The general observation, neuroelectrophysiology detection, histological observation, image analysis and evaluation of facial nerve regeneration recovery were performed at 8 weeks after surgery. RESULTS AND CONCLUSION： The action potentiat latency of the orbicutaris otis at the experimentat side was significantly lower than that at the control side, and the action potential amplitude （M wave） of compound nerve muscle of the experimental side was significantly higher than that of the control side （P 〈 0.01）. Compared with the control side, the regenerative nerves of the experimental side were more mature with more regenerative axons, and the differentiation of myelin sheath was more mature and the thickness of myelin sheath was well-distributed. Meanwhile, the diameters of axons were closed to the normal diameter, and the nerve axons were more intensive and arranged more regularly, the outer membrane of nerve fiber was thicker and the collagen fiber and elastic fiber layer were increased when compared with the control group. The number of regenerative axons of the control side was less, and the axons were distributed irregularly and poorly developed, and a large number of fibrous connective tissues were observed. The vacuolar degeneration at the control side was more than the experimental side. The regenerated nerve in the experimental side was better than the control side in the diameter of myelinated axon, area, myelin sheath thickness and axon count, and there were significant differences between two groups （P 〈 0.01 ）. It indicates that platelet rich plasma has a promoting effect in the repair and regeneration of facial nerve.