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find Author "郑加法" 2 results
  • NERVE TRANSPLANTATION AND ACCOMPANYING PERIPHERAL VESSELS FOR REPAIR OF LONG NERVE DEFECT

    Objective To observe the revascularization process of transplanted nerve after transplantation of long nerve and accompanying peri pheral vessels, to investigate its relationship with nerve regeneration. Methods The mediannerve defect models of the left forelimb (3 cm in length) were made in 60 New Zealand rabbits (aged 6-8 months, weighing 2.0-2.5 kg, and male or female), which were randomly divided into 2 groups (n=30). In situ anastomosis of the median nerves was performed in the control group; in situ anastomosis of the median nerves was made in parallel to the surrounding elbow veins, the transplanted epineurium and the adventitia were sutured with nerve anastomosis l ine in the experimental group. After operation, the gross observation, electrophysiological testing, and histopathology observation was performed at 1, 2, 4, 8, and 12 weeks, and transmission electron microscope at 12 weeks to observe the revascularization of nerve grafts, nerve fiber regeneration, and functional recovery. Results In the experimental group, revascularization was observed at 1 week after operation, and the degree of revascularization was significantly higher than that in the control group at 2, 4, 8, and 12 weeks. At 8 and 12 weeks, the nerve fiber regeneration speed, quality, and quantity in the experimental group were better than those in the control group. At 2, 4, 8, and 12 weeks, the nerve conduction velocities were (10.32 ± 0.94), (13.14 ± 1.22), (22.68 ± 1.16), and (24.09 ± 1.27) m/ s respectively in the experimental group, and were (9.18 ± 1.07), (11.12 ± 1.03), (19.81 ± 1.37), and (20.67 ± 1.19) m/s in the control group, showing significant difference at 12 weeks after operation (t=3.167, P=0.001). At 12 weeks in the experimental group, the myel in sheath had similar size, less sheath plate delamination, normal Schwann cells and rich organelles, in which normal microfilaments, microtubules and axonal mitochondria were observed; axonal mitochondria had clear crestfilm and no swelling and vacuolization, and the neurofibrils basically became normal. The myelinated nerve fibers area, myelin thickness, and axon diameter were (5.93 ± 0.94) mm2, (0.72 ± 0.12) μm, and (3.12 ± 0.12) μm respectively in the experimental group, and were (5.28 ± 0.72) mm2, (0.65 ± 0.09) μm, and (2.98 ± 0.16) μm respectively in the control group, all showing significant differences (t=3.736, P=0.002; t=3.271, P=0.002; t=4.533, P=0.001). Conclusion The transplanted nerves in parallel to large blood vessels can promote angiogenesis of the transplanted nerve, and accelerate the regeneration and functional recovery of the nerves.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 微创克氏针髓内固定治疗第五掌骨颈骨折

    目的总结应用2枚克氏针经髓撬拨复位髓内固定治疗第5掌骨颈骨折的疗效。 方法2013年5月-2015年4月,应用2枚克氏针经髓撬拨复位髓内固定治疗32例第5掌骨颈骨折患者。男31例,女1例;年龄17~42岁,平均24.6岁。均为握拳锤击外物致闭合性骨折。受伤至入院时间0.5~7 d,平均1.2 d。影像学检查示,掌骨头无骨折,骨折有明显侧方移位、掌侧移位。 结果术后切口均Ⅰ期愈合。32例均获随访,随访时间3~6个月,平均4.2个月。2例术后复查X线片示掌骨头向远端分离移位,行手法复位;其余患者均于术后4~6周拔除克氏针,平均4.4周。骨折愈合时间10~13周,平均11.3周。术后3个月患侧掌指关节活动度为(85.719±4.136)°,与健侧(87.250±2.369)°比较,差异无统计学意义(t=1.912,P=0.065)。第5掌骨头无塌陷、小指无旋转畸形。 结论采用2枚克氏针经髓撬拨复位髓内固定治疗第5掌骨颈骨折创伤小,操作简便,术后无需石膏外固定,可以早期活动掌指关节及腕关节,手部功能恢复较快。

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