CAJ | 학술논문

背景:有研究尝试将外源性鼠神经生长因子用于周围神经损伤局部,发现局部注射鼠神经生长因子能有效促进损伤神经修复,且局部应用效果优于全身应用.目的:评价明胶海绵浸润鼠神经生长因子用于治疗周围神经损伤的临床疗效.方法:纳入单一、完全断裂周围神经损伤患者36例,其中男16例,女20例,年龄18-48岁,采用随机数字表法均分为2 组,实验组急诊行清创、神经端端直接吻合,术中将浸润鼠神经生长因子的明胶海绵环绕包裹于神经吻合处;对照组急诊行清创、神经端端直接吻合,吻合神经处不予特殊处理.两组术后常规石膏固定,抗炎、营养神经、改善循环治疗.治疗后4周进行电生理检查,治疗后6个月进行神经损伤远端感觉、运动功能评价.结果与结论:实验组感觉电位恢复14例,恢复率为78%;运动电位恢复15例,恢复率为83%.对照组感觉电位恢复10例,恢复率为57%;运动电位恢复12例,恢复率为66%.两组间感觉、运动电位恢复率比较差异有显著性意义(P < 0.05).实验组17例神经功能得到不同程度恢复,总有效率为94%;对照组15例神经功能得到不同程度恢复,总有效率为83%,两组间总有效率比较差异有显著性意义(P < 0.05).表明局部应用明胶海绵浸润鼠神经生长因子可有效促进周围神经损伤的修复,且具有良好的生物相容性.
배경:유연구상시장외원성서신경생장인자용우주위신경손상국부,발현국부주사서신경생장인자능유효촉진손상신경수복,차국부응용효과우우전신응용.목적:평개명효해면침윤서신경생장인자용우치료주위신경손상적림상료효.방법:납입단일、완전단렬주위신경손상환자36례,기중남16례,녀20례,년령18-48세,채용수궤수자표법균분위2 조,실험조급진행청창、신경단단직접문합,술중장침윤서신경생장인자적명효해면배요포과우신경문합처;대조조급진행청창、신경단단직접문합,문합신경처불여특수처리.량조술후상규석고고정,항염、영양신경、개선순배치료.치료후4주진행전생리검사,치료후6개월진행신경손상원단감각、운동공능평개.결과여결론:실험조감각전위회복14례,회복솔위78%;운동전위회복15례,회복솔위83%.대조조감각전위회복10례,회복솔위57%;운동전위회복12례,회복솔위66%.량조간감각、운동전위회복솔비교차이유현저성의의(P < 0.05).실험조17례신경공능득도불동정도회복,총유효솔위94%;대조조15례신경공능득도불동정도회복,총유효솔위83%,량조간총유효솔비교차이유현저성의의(P < 0.05).표명국부응용명효해면침윤서신경생장인자가유효촉진주위신경손상적수복,차구유량호적생물상용성.
BACKGROUND:Several studies have attempted to apply mouse nerve growth factor to local lesions of peripheral nerve and found that local injection of mouse nerve growth factor can promote nerve recovery, which is superior to systematic application. OBJECTIVE:To evaluate the clinical effects of gelatin sponge infiltrated by mouse nerve growth factor in the repair of peripheral nerve injury. METHODS:Thirty-six patients with single peripheral nerve injury, including 16 males and 20 females, aged 18-48 years, were randomly divided into two groups: 18 patients in case group underwent debridement and neuroanastomosis, and then the injured nerve was wrapped by gelatin sponge which was infiltrated by mouse nerve growth factor and folowed by plaster fixation, anti-inflammatory therapy, neurotrophy and circulation improvement therapy; the other 18 patients in control group were treated only with debridement and neuroanastomosis and other conventional therapies. At 4 weeks after treatment, electrophysiological examination was performed. In addition, sensory and motor function of the distal end of injured nerve was evaluated at 6 months after treatment. RESULTS AND CONCLUSION: Sensory evoked potential and motor evoked potential showed that the recovery rate was 78% (n=14) and 83% (n=15) respectively in the case group, while 57% (n=10) and 66% (n=12) in the control group. There was significant difference between the two groups (P < 0.05). The total effective rate was 94.4% (n=17) in the case group and 83.3% (n=15) in the control group, which were statisticaly better in the case group than the control group (P < 0.05). These findings indicate that it is significantly effective to treat peripheral nerve injury by gelatin sponge infiltrated by mouse nerve growth factor that has good biocompatibility.