Repair of Peripheral Nerve Gaps with Lyophilized Autogenous Venous Conduits

當周邊神經因缺損而無法直接縫合時，臨床上可以利用一段自体靜脈當作導管以引導神經生長接合。一般而言，神經再生的效果要比以可吸收的合成導管要差。原因是靜脈本身較沒有彈性，容易受到周圍組織的壓擠而影響神經的再生。為了增加靜脈的彈性，我們將其以純酒精脫水處理。並比較脫水處理過的靜脈以及沒有特別處理過的靜脈當作導管吻合神經時，何者神經生長較佳。我們以老鼠脛神經為實驗，將其切除0.5公分後；一組動物其神經斷端是以0.75公分長之股靜脈吻合,另一組則以純酒精處理過之脫水股靜脈當作導導管。經過三個月後再取出靜脈導管。兩組導管中均充滿再生之神經組織。而比較中央棋切面有鞘神經軸突數目，發現使用脫水處理過之靜脈導管組與未處理過者在神經再生上結果相似。但在顯微吻合手術中，脫水處理過之靜脈其管壁較有彈性，手術操控性較佳而花在吻合上的時間也較少。這種方法應有其臨床應用價值。

關鍵字

無資料

並列摘要

Both auto genous veins and bioabsorbable tubes have been used experimentally and clinically as conduits through which to bridge gaps in peripheral nerves. However, peripheral nerves have been shown to regenerate across gaps better through bioabsorbable tubes than through autogenous veins. The reason for this is probably that autogenous veins lack sufficient external support, thereby impeding some regenerating units from reaching distal target organs. This study describes a modification of the traditional autogenous vein graft technique. Five mm segments of the posterior tibial nerves of Spraque-Dawley rats were resected. In one group, each gap was bridged with a 7.5mm segment of lyophilized femoral vein. The veins were lyophilized by bathing them in pure alcohol and then irrigating them with normal saline. In a second group , each gap was simply bridged with an unlyophilized femoral vein that had been merely irrigated with normal saline. The regenerating ability through both lyophilized or unlyophilized venous conduits was judged by comparing the number of regenerated vessels and myelinated axons. Both groups achieved comparable nerve regeneration. However, using lyophilized autogenous veins has the advantage of taking less time for microanastomosis and being easier to handle.

並列關鍵字

autogenous venous conduit ； nerve gap

國際替代計量

Repair of Peripheral Nerve Gaps with Lyophilized Autogenous Venous Conduits

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