人去细胞异体神经一期移植重建手指神经缺损

1、人去细胞异体神经一期移植重建手指神经缺损尽管周围神经损伤伴缺损的治疗金标准仍然是自体神经移植修复，但是近些年来各种各样的人工生物套管以及同种异体神经在神经缺损修复当中扮演着越来越重要的角色，其中最具潜力替代自体神经的移植物是人脱细胞神经。与传统方法相比，人去细胞神经不存在任何供体受区的损伤，且来源广泛。化学去细胞处理后的异体神经既保留了原有的结构又降低了免疫源性，且术后无需服药。尽管同种异体神经临床的使用还处于初期阶段，但修复指神经缺损的临床效果都较为确定。在既往的研究当中，神经移植重建都在损伤后1周或数周以后进行，主要考虑到伤口稳定以及减少术后炎症的发生比率。缺点就是患者需要进行2次手术，增

2、加了住院和康复时间。来自中国宁波市第六医院的李学渊所在团队首次将人体去细胞异体神经应用于手外伤急诊手术修复。针对急诊15例患者的18指神经损伤伴缺损，彻底清创后，以人体去细胞神经移植重建指神经。重建后随访6-24个月。静态两点辨别觉结果优良率为89%；轻触觉明显改善率为78%。提示人体去细胞神经移植一期重建手外伤指神经缺损临床操作可行，为缺损周围神经的重建提供了新趋向。相关文献发表于中国神经再生研究（英文版）杂志2015年1月第1期。以人体去细胞神经移植重建指神经损伤伴缺损Article: " One-stage human acellular nerve allograft rec

3、onstruction for digital nerve defects," by Xue-yuan Li1, Hao-liang Hu1, Jian-rong Fei1, Xin Wang1, Tian-bing Wang2, Pei-xun Zhang2, Hong Chen1 (1 Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo, Zhejiang Province, China; 2 Department of Trauma and Orthopedics, Peking University Peoples

4、 Hospital, Beijing, China)Li XY, Hu HL, Fei JR, Wang X, Wang TB, Zhang PX, Chen H (2015) One-stage human acellular nerve allograft reconstruction for digital nerve defects. Neural Regen Res 10(1):95-98.欲获更多资讯：Neural Regen Res One-stage human acellular nerve allograft reconstruction for digital nerve

5、 defectsAutologous nerve graft repair has become a gold standard for the treatment of peripheral nerve injury combined with defects. However, a variety of biological conduits and nerve allografts have played increasingly important roles in the repair of nerve defects. Human acellular nerves have bec

6、ome the most promising substitute for autologous nerve grafts. Compared with traditional methods, human acellular nerves do not induce damage to affected areas of the donor, and there is a wide variety of sources. With developments in medical technology, nerve allografts after acellular treatment ha

7、ve been shown to retain the original structure and reduce immunogenicity. Moreover, patients do not have to take medicine following surgery. The clinical use of nerve allografts is still in the early stages, but studies have shown positive clincial repair outcomes of digital nerve defects.In previou

8、s studies, nerve graft reconstruction was conducted at 1 week or several weeks after injury, resulting in wound stability and reduced incidence rate of postoperative inflammation. The disadvantage of this method is that patients require two surgeries, which increased hospitalization and recovery tim

9、e.Xue-yuan Li, Ningbo No.6 Hospital, China and his colleagues first used human acellular nerve allograft to reconstruct < 5-cm digital nerve defects in 18 digits of 15 patients with nerve injury from the emergency department. The patients were followed up for 624 months after reconstruction. Mack

10、innon-Dellon static two-point discrimination results showed excellent and good rates of 89%. Semmes-Weinstein monofilament test demonstrated that light touch was normal, with an obvious improvement rate of 78%. These findings confirmed that human acellular nerve allograft for one-stage reconstructio

11、n of digital nerve defect after hand injury is feasible, which provides a novel trend for peripheral nerve reconstruction. The relevant article was published in the Neural Regeneration Research (Vol. 10, No. 1, 2015).Reconstruction of nerve injury accompanied by defects using human accellular nerve

12、allograft.Article: " One-stage human acellular nerve allograft reconstruction for digital nerve defects," by Xue-yuan Li1, Hao-liang Hu1, Jian-rong Fei1, Xin Wang1, Tian-bing Wang2, Pei-xun Zhang2, Hong Chen1 (1 Department of Hand Surgery, Ningbo No.6 Hospital, Ningbo, Zhejiang Province, China; 2 Department of Trauma and Orthopedics, Peking University Peoples Hospital