中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (16): 3010-3017.doi: 10.3969/j.issn.2095-4344.2013.16.023

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

合成材料神经导管与自体神经移植修复周围神经缺损的比较

罗鹏1，彭邱亮2，向剑平3，戚剑3   

  1. 1深圳市第六人民医院骨一科，广东省深圳市  518054
    2广州中大医疗器械公司医学部，广东省广州市  510275
    3中山大学附属第一医院显微创伤外科，广东省广州市  510080
  • 收稿日期:2012-12-29 修回日期:2013-02-19 出版日期:2013-04-16 发布日期:2013-04-16
  • 通讯作者: 戚剑，博士，副教授，中山大学附属第一医院显微创伤外科，广东省广州市 510080 speedsnow@126.com
  • 作者简介:罗鹏☆，男，1980年生，河北省石家庄市人，汉族，2012年中山大学中山医学院毕业，博士，医师，主要从事周围神经相关研究 gaidihu0308@sina.com
  • 基金资助:

     国家自然科学基金资助项目(30571913)。

Synthetic nerve conduit versus autogenous nerve transplantation for repair of peripheral nerve defects

Luo Peng1, Peng Qiu-liang2, Xiang Jian-ping3, Qi Jian3   

  1. 1 First Department of Orthopedics, Shenzhen Sixth People’s Hospital, Shenzhen  518054, Guangdong Province, China
    2 Department of Medicine, Guangzhou Zhongda Medical Device Company, Guangzhou  510275, Guangdong Province, China
    3 Department of Microscopy Traumatic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou  510080, Guangdong Province, China
  • Received:2012-12-29 Revised:2013-02-19 Online:2013-04-16 Published:2013-04-16
  • Contact: Qi Jian, Doctor, Associate professor, Department of Microscopy Traumatic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China speedsnow@126.com
  • About author:Luo Peng☆, Doctor, Physician, First Department of Orthopedics, Shenzhen Sixth People’s Hospital, Shenzhen 518054, Guangdong Province, China gaidihu0308@sina.com
  • Supported by:

     National Natural Science Foundation of China, No. 30571913*

PDF

941

被引次数

15

摘要：

背景：生物可降解材料制成的神经导管可在体内降解，避免出现的神经卡压等问题，因而受到越来越多的关注。
目的：比较自体神经移植与3种合成可生物降解材料神经导管在修复周围神经损伤的效果差异。
方法：通过电生理学检测，形态学观察等神经恢复效果评价方法，对比分析近年来常用的胶原神经导管、DL-乳酸-ε-己内酯神经导管、聚乙醇酸神经导管与自体神经移植修复周围神经缺损的效果。
结果与结论：虽然神经导管与自体神经移植相比在理论上有其优势的一面，但不同合成材料的神经导管之间在神经功能恢复中存在明显差异性，DL-乳酸-ε-己内酯神经导管修复效果与自体神经移植无明显差异，是较为理想的神经导管材料，聚乙醇酸神经导管因自身的因素影响其降解性能，在3种神经导管中的修复周围神经损伤效果最差，胶原神经导管需要交联剂改善其机械性能，其修复周围神经损伤效果居于前两者之间，因此，这3种神经导管在神经功能再生方面还有潜在的缺陷，不能完全替代自体神经移植，而且3者之间的性价比，还缺少足够的大样本长期随机对照实验结果来验证，还需要进一步的实验观察。

关键词: 生物材料, 生物材料学术探讨, 周围神经导管, 周围神经缺损, 周围神经缺损修复, 神经再生, 周围神经, 神经移植, 合成材料, 可降解生物材料, DL-乳酸-ε-己内酯, 聚乙醇酸, 胶原蛋白, 电生理学, 病理学, 国家自然科学基金

Abstract:

BACKGROUND: As the biodegradable materials produced nerve conduit can be degraded in vivo and can avoid the nerve entrapment, it has attracted more and more attentions.
OBJECTIVE: To compare the effect of autogenous nerve transplantation and three kinds of synthetic biodegradable materials produced nerve conduit for the repair of peripheral nerve defects.
METHODS: The effect of commonly used collagen nerve conduit, DL-lactic acid-ε-caprolactone nerve conduit, polyglycolic acid nerve conduit and autogenous nerve transplantation in the repair of peripheral nerve defects was evaluated with electrophysiological detection and morphological observation.
RESULTS AND CONCLUSION: Theoretically, the nerve conduit has some advantages when compared with autogenous nerve transplantation, but there was significant difference in neural functional recovery between different synthetic materials produced nerve conduits. The repair effect of DL-lactic acid-ε-caprolactone nerve conduit was similar to that of autogenous nerve transplantation, and was considered as the ideal nerve conduit material; due to the disadvantages of polyglycolic acid nerve conduit which can inhibit its degradation, polyglycolic acid nerve conduit showed least effect in repairing peripheral nerve defects among three kinds of nerve conduits; collagen nerve conduit could improve the mechanical properties with the help of crosslinker, so the effect in repairing peripheral nerve defects was lower than DL-lactic acid-ε-caprolactone nerve conduit and higher than polyglycolic acid nerve conduit. These three kinds of nerve conduits have their potential shortcomings in nerve function regeneration, so that can not completely replace autogenous nerve transplantation. There still lacks of large sample long-term randomized controlled experiments to identify the performance price ratio between three kinds of nerve conduits. Further experimental observations are needed.

Key words: biomaterials, biomaterial academic discussion, peripheral nerve conduit, peripheral nerve defects, peripheral nerve defect restoration, neural regeneration, peripheral nerve, nerve transplantation, synthetic materials, biodegradable materials, DL-lactic acid-ε-caprolactone, polyglycolic acid, collagen, electrophysiology, pathology, National Natural Science Foundation of China

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