Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (18): 2890-2899.doi: 10.3969/j.issn.2095-4344.2017.18.017
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Received:
2017-01-16
Online:
2017-06-28
Published:
2017-07-07
Contact:
Tian De-hu, M.D., Chief physician, Professor, Third Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
About author:
Ma Tao, Master, Third Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Supported by:
the Natural Science Foundation of Hebei Province, No. ZL20140066
CLC Number:
Ma Tao, Kou Wen-guan, Liu Guo-li, Bai Jiang-bo, Yu Kun-lun, Tian De-hu. Fresh amniotic membrane for repair of acute peripheral nerve injury[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(18): 2890-2899.
2.1 实验动物数量分析 SD大鼠60只,随机分为3组,每组20只。最终人羊膜组19只、生物膜组18只、空白对照组19只进入结果分析,因死亡脱落3只,逃跑1只。 2.2 大体观察结果 见图1。①3组大鼠手术切口均未出现感染,7 d切口拆线,切口一级愈合;②3组大鼠术后2周大部分出现手术侧下肢稍肿胀且跛行,精神状态差,进食减少。2周后肿胀、精神状态及饮食逐渐恢复,人羊膜组、生物膜组大鼠跛行时间较空白对照组短,活动量恢复更早;③人羊膜组、生物膜组与空白对照组相比足底和足趾皮肤溃疡大鼠数量少且溃疡恢复时间短;④术后2周,羊膜、生物膜局部稍有吸收,4周大部吸收,8,12周完全吸收;⑤人羊膜组、生物膜组神经和周围组织粘连较轻且粘连较疏松,活动度可,空白对照组神经和周围组织粘连广泛、紧密,不易分离。"
2.3 光镜观察结果 见图2-5。 术后2周:人羊膜组、生物膜组吻合口周围炎性细胞明显增多,许旺细胞增生,且排列紊乱,大量纤维组织增生。空白对照组吻合口周围大量炎性细胞浸润,纤维组织增生明显,吻合口周围杂乱无章。 术后4周:人羊膜组、生物膜组许旺细胞数量较前有所增加,并且形成了细胞索,炎性细胞较前有所减少,有部分神经轴突生长。空白对照组有许旺细胞增生,炎性细胞较前减少,但神经再生较少,并且有少量髓鞘碎片存在。 术后8周:3组中髓鞘碎片消失,再生神经纤维增多。人羊膜组、生物膜组炎性细胞基本消失,许旺细胞排列较规律,神经纤维较粗。空白对照组仍存在少量炎性细胞,许旺细胞排列较规律,但神经纤维较人羊膜组、生物膜组细。 术后12周:3组炎性细胞均基本消失,人羊膜组、生物膜组比空白对照组神经纤维密集且髓鞘厚度更厚。"
2.6 轴突图像分析 见表1-3。 术后4周:3组再生神经远段横截面有髓神经纤维数目较少,髓鞘厚度较薄,结构不成熟。人羊膜组、生物膜组吻合口远端横截面再生的有髓神经纤维数目、平均直径及髓鞘厚度均优于空白对照组,人羊膜组与空白对照组比较差异有显著性意义(P < 0.05),人羊膜组与生物膜组相比差异无显著性意义(P > 0.05)。 术后8,12周:3组吻合口远端横截面再生的有髓神经纤维数目、平均直径及髓鞘厚度均有所增加。人羊膜组、生物膜组吻合口远端横截面再生的有髓神经纤维数目、平均直径及髓鞘厚度均优于空白对照组,人羊膜组与空白对照组比较差异有显著性意义(P < 0.05),人羊膜组与生物膜组相比差异无显著性意义(P > 0.05)。"
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