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1、醫(yī)學(xué)論文-去抗原同種異體靜脈套接修復(fù)兔面神經(jīng)損傷【摘要】?以經(jīng)生物工程處理的靜脈導(dǎo)管為支架,應(yīng)用兔為動(dòng)物實(shí)驗(yàn)對(duì)象,觀察該方式修復(fù)面神經(jīng)損傷的特點(diǎn)?!痉椒ā浚担粗恍挛魈m大白兔,每只實(shí)驗(yàn)兔分別應(yīng)用靜脈導(dǎo)管及自體神經(jīng)移植吻合修復(fù)面神經(jīng)損傷,手術(shù)后行大體觀察、生物機(jī)能實(shí)驗(yàn)系統(tǒng)記錄神經(jīng)動(dòng)作電位、切片組織學(xué)檢查。【結(jié)果】活體動(dòng)物手術(shù)后觀察,靜脈導(dǎo)管側(cè)胡須運(yùn)動(dòng)、上唇口輪匝肌運(yùn)動(dòng)及其運(yùn)動(dòng)幅度比自體神經(jīng)組稍多;生物機(jī)能實(shí)驗(yàn)系統(tǒng)記錄神經(jīng)動(dòng)作電位,術(shù)后10周和15周時(shí)靜脈導(dǎo)管側(cè)和自體神經(jīng)側(cè)均可引出神經(jīng)動(dòng)作電位,靜脈導(dǎo)管側(cè)的神經(jīng)傳導(dǎo)速度平均值均高于自體神經(jīng)側(cè);術(shù)后10周,各兔再生神經(jīng)組織化學(xué)
2、染色,靜脈導(dǎo)管側(cè)的再生有髓神經(jīng)纖維分布密集,并見(jiàn)分裂成熟的面神經(jīng)結(jié)構(gòu),自體神經(jīng)側(cè)染色的神經(jīng)纖維分布稍稀疏,再生的有髓神經(jīng)結(jié)構(gòu)不完全成熟?!窘Y(jié)論】利用生物性天然靜脈導(dǎo)管,經(jīng)生物工程技術(shù)處理,克服了天然生物材料引起宿主的免疫排斥反應(yīng),比應(yīng)用自體神經(jīng)移植更有利于促進(jìn)神經(jīng)再生和功能恢復(fù)?!娟P(guān)鍵詞】?生物工程靜脈導(dǎo)管修復(fù)面神經(jīng)損傷 Abstract:【Objective】Therepairofthefacialnerveinjuryofrabbitswasexploredbyusingthevenousconduits.?【Methods】Thefacialnerveinju
3、ryoffifty-fourmaleNewZealandrabbitsweretreatedbyvenousconduitsandautonervegrafts.Afteroperations,themacroscopicobservations,detectionsofnerveactionpotentialsandhistologicalevaluationsonrabbitswereperformed.【Results】Macroscopicfindings:Thefrequencyandamplitudeofmovementsofvibrissaeandorb
4、icularisorismuscleoftheupperlipwereimprovedalittleinthesidesofvenousconduitscomparedwiththatinthesidesofautografts.Electrophysiologicalexaminations:nerveactionpotentialscouldbedetectedinbothsidesofvenousconduitsandautograftsat10weeksand15weekspostoperatively,respectively.Themeanvelocity
5、ofnerveconductioninthesidesofvenousconduitswasgreaterthanthatinthesidesofautografts.?Histologicexaminations:at10weekspostoperatively,inthesidesofvenousconduit,regeneratedmedullatednervefibersweredistributeddenselywithmaturefacialnervestructure.Whileinthesidesofautografts,regeneratednerv
6、efibersweredistributedsparselywithimmaturemedullatednervestructure.【Conclusion】Thenaturalvenousconduitprocessedbybioengineeringtechnologyaddressestheimmunologicrejectionofthehost,andofferedgreaterpromotioninregardtoregenerationandfunctionalrecoveryofnervescomparedwithautologousnervegraf
7、ts. ?。耍澹鳎铮颍洌螅海猓椋铮澹睿纾椋睿澹澹颍椋睿?;venousconduit;repair;facialnerveinjury 面神經(jīng)損傷可并發(fā)于巖骨骨折,也可為橋腦、小腦腳腫瘤或顱底腫瘤手術(shù)引起[1-3]。面神經(jīng)是面部肌肉主要的運(yùn)動(dòng)神經(jīng),對(duì)維持面部在靜態(tài)、動(dòng)態(tài)的勻稱(chēng)和面部表情的產(chǎn)生具有重要作用。面神經(jīng)損傷引起眼瞼閉合不全、面肌癱瘓、萎縮,最終引起失明、面部畸形,嚴(yán)重影響面部美觀、功能及患者的日常生活及社會(huì)活動(dòng)。面神經(jīng)損傷后再生是一個(gè)復(fù)雜的過(guò)程,涉及生物、生理、化學(xué)等諸多因素,人們尚未對(duì)這一過(guò)程徹底解決。近幾十年來(lái),隨著顯微外科技術(shù)的日趨完