本文選題：舌重建 + 睫狀神經(jīng)生長因子　； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：建立攜帶肋間神經(jīng)的腹直肌-腹膜瓣修復(fù)舌缺損的比格犬動物模型,.將肋間神經(jīng)與舌下神經(jīng)吻合,通過觀察應(yīng)用與不應(yīng)用睫狀神經(jīng)生長因子(ciliary neurotrophic factor, CNTF),評價再生神經(jīng)數(shù)量及功能恢復(fù)差異,為功能性舌重建提供實驗依據(jù)。方法：將18只健康雄性比格犬,犬齡1-1.5歲,分別編號,按隨機數(shù)字表分為兩組(A、B組),每組9只。首先兩組在舌體左側(cè)制備舌缺損,以左下第一磨牙近中至舌中線的垂直連線為前界切除4cm×3cm范圍的舌體組織,然后兩組分別制備攜帶第11肋間神經(jīng)和腹壁下動、靜脈的腹直肌-腹膜瓣。將第11肋間神經(jīng)和舌下神經(jīng)吻合,腹壁下動、靜脈分別與舌動脈、頜外靜脈吻合,腹直肌-腹膜瓣修復(fù)舌缺損。兩組神經(jīng)吻合段均置于硅膠管內(nèi),兩端以膠原蛋白海綿封閉。吻合完成后A組硅膠管內(nèi)一次性注入CNTF300ng(5ul,60ng/ul), B組硅膠管內(nèi)注入5u1生理鹽水。術(shù)后12周,兩組動物模型進行舌下神經(jīng)電生理檢測,再生神經(jīng)有髓纖維、運動纖維計數(shù),神經(jīng)直徑、移植腹直肌細(xì)胞直徑、面積測量。結(jié)果：電生理檢測結(jié)果為A、B兩組潛伏期較正常明顯延長,A組潛伏期較B組短,A、B兩組振幅較正常降低,A組振幅大于B組,A、B兩組傳導(dǎo)速度較正常減慢,A組傳導(dǎo)速度恢復(fù)優(yōu)于B組,差異均有統(tǒng)計學(xué)意義(P0.05)；A、B兩組再生神經(jīng)直徑,有髓纖維、運動纖維計數(shù)比較,A組再生神經(jīng)直徑、有髓神經(jīng)纖維、運動神經(jīng)纖維數(shù)量大于B組,差異均有統(tǒng)計學(xué)意義(P0.05)；A、B兩組轉(zhuǎn)移腹直肌細(xì)胞比較,A組細(xì)胞直徑、面積大于B組,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論：攜帶肋間神經(jīng)的腹直肌腹膜瓣轉(zhuǎn)移修復(fù)舌缺損后,兩組模型肋間神經(jīng)可重獲舌下神經(jīng)支配,局部應(yīng)用CNTF可促進運動神經(jīng)再生,舌下神經(jīng)功能恢復(fù)優(yōu)于未使用CNTF組,并能有效防止轉(zhuǎn)移腹直肌腹膜瓣萎縮
[Abstract]:Objective: to establish a biger dog model of repairing tongue defect with rectus abdominis and peritoneal flap carrying intercostal nerve. The intercostal nerve and hypoglossal nerve were anastomosed to evaluate the difference in the number and function of regenerated nerve by observing the application and non-application of ciliary nerve growth factor (ciliary neurotrophic factor) in order to provide experimental basis for functional tongue reconstruction. Methods: eighteen healthy male Beagle dogs aged 1 to 1.5 years old were divided into two groups according to the random number table, 9 in each group. At first, the tongue defect was prepared on the left side of the tongue body. The vertical line from the middle to the middle line of the left first molar was used as the anterior boundary to remove the tongue tissue in the 4cm 脳 3cm area. Then, the second group was prepared to carry the 11th intercostal nerve and the inferior abdominal wall movement, respectively. Rectus abdominis-peritoneal flap of vein. The 11th intercostal nerve was anastomosed with hypoglossal nerve, inferior abdominal artery and vein were anastomosed with lingual artery, external maxillary vein and rectus abdominis peritoneum flap respectively to repair tongue defect. The nerve anastomoses of the two groups were placed in a silicone tube and closed with collagen sponge at both ends. After the anastomosis was completed, CNTF 300 ng / L 5 ulng / L was injected into the silicone tube in group A and 5u1 saline was injected into the silicone tube in group B. 12 weeks after operation, the hypoglossal nerve electrophysiological examination was performed in the two groups. The regenerated nerve myelinated fiber, motor fiber count, nerve diameter, the diameter and area of the transplanted rectus abdominis cells were measured. Results: the results of electrophysiological examination showed that the latency of group A was shorter than that of group B, the amplitude of group A was lower than that of group B, the amplitude of group A was larger than that of group B and the conduction velocity of group A was lower than that of group B. The recovery of conduction velocity in group A was better than that in group B. There were significant differences in the diameter of regenerated nerve and the number of myelinated fibers in group A, and the number of regenerated nerve fibers, myelinated nerve fibers and motor nerve fibers in group A were higher than those in group B. There were significant differences in the diameter and area of metastatic rectus abdominis cells in group A and group B, and the difference was statistically significant (P 0.05). Conclusion: after the transfer of rectus abdominis peritoneal flap carrying intercostal nerve to repair tongue defect, the intercostal nerve of the two groups can regain the hypoglossal nerve innervation, local application of CNTF can promote the regeneration of motor nerve, and the recovery of hypoglossal nerve function is better than that of non-CNTF group. It can effectively prevent rectus abdominis from atrophy.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.57

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