CAJ | 학술논문

目的探讨组织工程化人工神经修复盆腔内脏运动神经缺损的效果,为解决直肠癌手术盆腔植物神经损伤所致性功能障碍的治疗提供新思路和实验依据.方法以密度梯度离心法分离比格犬骨髓间充质干细胞(BMSCs),体外培养和扩增后备用.制作比格犬盆腔内脏运动神经10 mm缺损模型,分3组予以修复.A组:将BMSCs与胶原蛋白海绵混合移植于聚羟基乙酸和聚乳酸共聚物(PLGA)导管中构建组织工程化人工神经桥接盆腔内脏运动神经缺损段;B组:仅将胶原蛋白海绵移植于PLGA导管中桥接神经缺损段;C组:自体神经移植.术后12周移植段神经通过大体观察和免疫组织化学观察及电镜扫描、轴突计数等方法评价各组神经缺损修复的效果.结果术后12周,PLGA导管基本吸收,各组再生神经均能通过缺损区长至神经远端,A组再生神经纤维密度和神经结构与C组相近,均优于B组,差异有统计学意义(P<0.05).结论 BMSCs与PLGA导管构建组织工程化人工神经用于修复盆腔内脏运动神经缺损效果好,与自体神经移植效果相当.
목적 탐토조직공정화인공신경수복분강내장운동신경결손적효과,위해결직장암수술분강식물신경손상소치성공능장애적치료제공신사로화실험의거.방법 이밀도제도리심법분리비격견골수간충질간세포(BMSCs),체외배양화확증후비용.제작비격견분강내장운동신경10 mm결손모형,분3조여이수복.A조:장BMSCs여효원단백해면혼합이식우취간기을산화취유산공취물(PLGA)도관중구건조직공정화인공신경교접분강내장운동신경결손단;B조:부장효원단백해면이식우PLGA도관중교접신경결손단;C조:자체신경이식.술후12주이식단신경통과대체관찰화면역조직화학관찰급전경소묘、축돌계수등방법평개각조신경결손수복적효과.결과 술후12주,PLGA도관기본흡수,각조재생신경균능통과결손구장지신경원단,A조재생신경섬유밀도화신경결구여C조상근,균우우B조,차이유통계학의의(P<0.05).결론 BMSCs여PLGA도관구건조직공정화인공신경용우수복분강내장운동신경결손효과호,여자체신경이식효과상당.
Objective To investigate the outcome of repairing pelvic autonomic nerve defects with the tissue-engineered nerve, in order to provide a new method and experimental evidence for solving sexual disturbance induced by pelvic autonomic nerve injury after radical resection of rectal carcinoma. Methods Bone marrow stromal cells (BMSCs) were purified with density gradient centrifugation. A 10 mm defect of hypogastric nerve was created in 9 Beagle dogs and the 18 hypogastric nerves were randomly divided into three groups. Group A: nerve defects bridged with copolymer of lactic and glycolic acids (PLGA) tube containing BMSCs and collagen protein sponge. Group B: with PLGA tube only containing collagen protein sponge. Group C: with autologous nerve graft. The effect of nerve recovery was evaluated by morphology, HE staining, neurofilament immunohistochemistry staining, electron microscope scanning and measurement quantity of new axon 12 weeks after the transplantation. Results Twelve weeks after the transplantation, degradation of PLGA tubes showed in group A and group B. The nerves regenerated through defect area to distal end. The density of regeneration nerve fiber in group A and group C were better than that in group B. The difference was significant between group A or group C and group B (P<0.05), and no significant difference was observed between group A and group C(P> 0.05). Conclusion Tissue-engineered nerve, which is constructed by BMSCs mixed with collagen protein sponge and PLGA tube, can be used to bridge and repair the pelvic autonomic nerve defect.