CAJ | 학술논문

背景:近年来不断报道用自体周围神经植入治疗脊髓损伤的研究,但功能恢复尚不满意.目的:探讨自体肋间神经不同移植术式对治疗脊髓损伤疗效的影响.设计:随机对照的实验研究.地点和对象:在苏州大学附属第二医院实验中心完成.SD大鼠60只,来自苏州大学医学院实验动物中心,体质量176～291 g. 方法:采用SD鼠,经T8,T9平面切除4 mm长的半侧脊髓制成脊髓半切模型.分3组,分别用6～8条纤细的肋间神经节段按近端白质-远端灰质和近端白质-远端白质两种桥接术式填充缺损处,对照组用明胶海绵填充脊髓半切残腔.饲养4～6周,观察结果.主要观察指标:动物活动能力Tarlov评分,斜板试验,组织学观察.结果:两种术式受试鼠的后肢功能部分恢复,术后6周,A,B组Tarlov评分分别为(2.0±1.58),(2.1±1.20)分,均高于对照组,斜板试验临界角度分别为(42.2±2.94)°,(42.1±1.46)°,均较对照组明显提高;镜下见移植组织存活、充填于缺损处,部分与脊髓组织融合;组织、功能的恢复均明显优于对照组,但两种术式组间无明显差别.结论:脊髓半切模型可能是研究周围神经植入的合适模型,肋间神经可能是适合的周围神经植入材料,周围神经的桥接术式有待进一步研究.
배경:근년래불단보도용자체주위신경식입치료척수손상적연구,단공능회복상불만의.목적:탐토자체륵간신경불동이식술식대치료척수손상료효적영향.설계:수궤대조적실험연구.지점화대상:재소주대학부속제이의원실험중심완성.SD대서60지,래자소주대학의학원실험동물중심,체질량176～291 g. 방법:채용SD서,경T8,T9평면절제4 mm장적반측척수제성척수반절모형.분3조,분별용6～8조섬세적륵간신경절단안근단백질-원단회질화근단백질-원단백질량충교접술식전충결손처,대조조용명효해면전충척수반절잔강.사양4～6주,관찰결과.주요관찰지표:동물활동능력Tarlov평분,사판시험,조직학관찰.결과:량충술식수시서적후지공능부분회복,술후6주,A,B조Tarlov평분분별위(2.0±1.58),(2.1±1.20)분,균고우대조조,사판시험림계각도분별위(42.2±2.94)°,(42.1±1.46)°,균교대조조명현제고;경하견이식조직존활、충전우결손처,부분여척수조직융합;조직、공능적회복균명현우우대조조,단량충술식조간무명현차별.결론:척수반절모형가능시연구주위신경식입적합괄모형,륵간신경가능시괄합적주위신경식입재료,주위신경적교접술식유대진일보연구.
BACKGROUND: Recently, a lot of studies were reported on repair of injured spinal cord by transplanting autologous peripheral nerve. However, the functional recovery is not very satisfactory.OBJECTIVE: To explore the effects of different transplantation methods for autologous intercostal nerves on spinal cord injury(SCI).DESIGN: A randomized controlled experimental study.SETTING and PARTICIPANTS: The study was completed in the Laboratory of Second Hospital Affiliated to Suzhou University. Sixty SD rats,weighing 176 - 291 g, were provided by Center for Experimental Animals of Suzhou University.METHODS: SD rats were used to make spinal cord hemisection model by cutting a 4-mm-length one side of spinal cord from Ts and T9 and then divided into three groups. 6 to 8 tenuous intercostal nerve segments were used in the first group to fill the defect area by means of proximal white matter linking to distal part gray matter, while in the way of proximal white matter linking to distal white matter in the second group. The third group was used gelfoam to fill the defect as control group. Results were observed after 4 to 6 weeks of feeding.MAIN OUTCOME MEASURES: Tarlov scoring of animal activities; gradient plate test; histological observation.RESULTS: The functions of posterior limbs of rats in two experimental groups were partly restored. Six weeks after operation, the Tarlov scores of two groups were(2.0 + 1.58) and (2. 1 + 1.20) respectively which were all higher than that of control group. The critical angles of gradient plate test in two groups were (42.2 + 2.94) ° and (42.1 ± 1.46) ° respectively, bigger than that in control group. It was found that transplanted tissue survived and filled into defect and partly fused with spinal cord. The recoveries of tissue and function were all better than that of control group. However, there was no difference between two experimental groups.CONCLUSION: Spinal cord hemisection model may be the appropriate model to study the transplantation of peripheral nerves, while the intercostals nerves may be the suitable material for peripheral nerve transplantation. The bridging forms of peripheral nerve need further study.