運動神経修復に関する実験的研究 : フィブリン糊とナイロン糸による修復法の比較検討
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Experiments were performed on 20 Sprague-Dawley white rats. In 10 rats a simple neurotomy was performed in the sciatic nerve in the region between the superior gluteus branch and the division into peroneal and anterior tibial nerves. In the second group of 10 rats a 1cm segment of sciatic nerve was excised bilaterally. This segment was then reversed end-to-end and interposed into the defect. The neurotomy and the nerve graft were repaired on one side by microsurgical 10-0 nylon suture technique. The opposite side was repaired using two component fibrin adhesive. The results of the repair were assesed at 12 weeks after the operation. By inspection the success rate was 100% for the neurotomy repaires in both the nylon suture and fibrin adhesive repaires. For the nerve graft groups the repair was successful in 100% of nylon suture repairs and in 80% of the fibrin adhesive repairs. Functional assessment of nerve regeneration was performed in those rats with intact repair sites. Assessments consisted of measurement of nerve muscle twitch strength (NMTS) and compound action potential (CAP) parameters measured proximal and distal to the repair site. NMTSs were not significantly different (p>.05) between nerves repaired using nylon suture and fibrin adhesive. CAP parameters were significantly better (p<.05) in nerve grafts repaired using suture technique. The current animal model for fibrin adhesive repair is no better than nylon suture repair and may lead less effective nerve regeneration as determined by CAP parameter.
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