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目的:分析修复膜在大鼠腮腺切除术中对神经再生的屏蔽作用。方法:对40只雄性SD大鼠进行双侧腮腺部分切除术,左侧为实验侧,在腮腺表面置入修复膜;右侧为对照侧,直接将皮肤、皮下组织覆盖于腮腺表面。大鼠分为A、B 2组,每组20只,A组术中保护面神经,B组术中切断面神经颊支。在腮腺手术后1周、2周、4周、3个月、6个月,每组分别处死4只大鼠。在双侧腮腺咬肌区取材,进行HE染色及PGP9.5免疫组化染色,观察手术部位的愈合情况。采用SPSS13.0软件包对所有大鼠、A组、B组大鼠左、右侧表皮内神经纤维密度及真皮内神经纤维密度分别进行配对t检验。结果:置入修复膜的实验侧伤口愈合过程中,炎症细胞浸润多于对照侧。术后4周时,修复膜被自身组织替代。B组大鼠术后1周、2周、4周均可见神经瘤形成。B组大鼠左侧真皮内神经纤维密度小于右侧,差异具有显著性(P<0.05)。结论:修复膜可使切断面神经的大鼠真皮神经纤维数量减少,可在一定程度上阻止神经纤维的生长,初步揭示出腮腺表面置入修复膜对神经再生的屏障作用。
OBJECTIVE: To analyze the masking effect of repaired membrane on nerve regeneration during parotid gland resection in rats. Methods: Forty male SD rats were subjected to bilateral parotid partial resection. The left side was the experimental side and the repair membrane was placed on the parotid gland surface. The right side was the control side, and the skin and subcutaneous tissue were directly covered on the parotid gland surface. Rats were divided into groups A and B 2, with 20 rats in each group. Facial nerve was protected during operation in group A, and facial buccal branch was cut off in group B during operation. One week, two weeks, four weeks, three months and six months after parotid surgery, 4 rats were killed in each group. In bilateral parotid masseter area drawn, HE staining and PGP9.5 immunohistochemical staining to observe the surgical site of healing. The left and right epidermis nerve fiber density and intradermal nerve fiber density in all rats, A group and B group were analyzed by paired t-test using SPSS 13.0 software package. Results: During the wound healing process, the inflammatory cells infiltrated more than the control side. At 4 weeks after surgery, the repair membrane was replaced by its own tissue. B group of rats after 1 week, 2 weeks, 4 weeks can be seen neuroma formation. The density of nerve fibers in the left dermis of rats in group B was less than that in right sides, the difference was significant (P <0.05). Conclusion: The repairing membrane can reduce the number of cutaneous nerve fibers of cutaneous nerve in rats, which can inhibit the growth of nerve fibers to a certain extent, and initially reveal the barrier function of the repaired membrane on the regeneration of parietal nerve.