论文部分内容阅读
目的探索定向纤维蛋白水凝胶(aligned fibrin hydrogel,AFG)多分支支架复合聚乙二醇(polyethylene glycol,PEG)凝胶修复全面神经缺损的可行性。方法将12只新西兰大白兔随机均分为3组:AFG-PEG组、AFG组和自体神经组。3组动物均制造出面神经主干长3 mm、各分支长7 mm的全面神经缺损模型。AFG-PEG组将覆盖了PEG凝胶的AFG多分支支架植入全面神经缺损部位后,再用PEG凝胶覆盖支架与神经断端的连接处;AFG组采用AFG多分支支架桥接全面神经缺损部位;自体神经组将切除的自体全面神经复位缝合。术后1、6及12周对3组动物进行大体观察。术后12周取材,对各组移植物的主干以及上颊支和颧支的不同部位的组织样本进行组织学检测。结果 12只动物术后均存活,术区未见化脓及排异现象。AFG-PEG组的上颊支神经再生情况优于AFG组,该组靠近分叉方向的颧支部分有轴突再生;AFG组的材料降解程度较AFG-PEG组严重,该组上颊支和颧支的神经再生情况均很差;AFG-PEG组和AFG组的神经再生情况均差于自体神经组。结论 AFG可定向引导轴突再生,但由于其降解速度较神经再生速度快,复合PEG凝胶的AFG多分支支架以及单独的AFG多分支支架均不能很好地修复全面神经缺损。
OBJECTIVE: To investigate the feasibility of modified polyethylene glycol (PEG) gel with aligned fibrin hydrogel (AFG) multi-branched scaffolds for the repair of complete facial nerve defects. Methods Twelve New Zealand rabbits were randomly divided into three groups: AFG-PEG group, AFG group and autonomic group. Three groups of animals were all made of facial nerve trunk length of 3 mm, 7 mm in length of the branch of a comprehensive model of nerve defects. AFG-PEG group will be covered with PEG gel AFG multi-branch stent implanted in the full-thickness nerve defect site, and then covered with PEG gel scaffold and nerve end connections; AFG group using AFG multi-branch stent bridging full nerve defect ; Autologous nerve group resection of the total autonomic nerve suture. After 1, 6 and 12 weeks, three groups of animals were generally observed. Twelve weeks after the operation, the main stem of each group and the tissue samples of the different parts of the upper cheek and zygomatic branches were examined histologically. Results All 12 animals survived postoperatively, and no suppuration and rejection occurred in the surgical field. The superior cheek nerve regeneration in AFG-PEG group was better than that in AFG group. Axillary regeneration was found in the zygomatic branch near the bifurcation. The material degradation in AFG group was more serious than that in AFG-PEG group. The nerve regeneration of the zygomatic branches were poor. The nerve regeneration in the AFG-PEG group and the AFG group were worse than those in the autologous nerve group. Conclusion AFG can guide the axonal regeneration directionally. However, AFG multi-stent and AFG multi-stent alone can not completely repair the entire nerve defect because of its faster degradation than nerve regeneration.