引导周围神经生长的人工神经导管(尸体研究)

A. Fedyakov, E. A. Nemets, O. Dreval, A. V. Gorozhanin, L. A. Sidneva, Z. H. Plieva, M. A. Razin, N. V. Perova, V. Sevastianov
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摘要

目前,对周围神经解剖损伤的有效修复方法的探索仍在继续。自体成形术仍然是黄金标准,然而,它也不是没有缺点。使用神经植入物促进定向轴突生长是必要的和有前途的。目的:研究混合生物材料人工神经导管(NGC)实验室样品的生物力学性能,并在尸体材料上评价其用于外科修复延展性周围神经缺损的技术可行性。材料和方法。研究对象为三种电纺NGC样品:合成材料(聚己内酯、PCL)和混合生物材料(PCL +明胶或PCL +胶原)。研究比较了NGC的物理力学性能:刚度、塑性、弹性、脆性、抗化学侵蚀能力、液体介质浸透能力、渗透性、手术过程中植入物与神经吻合的可能性。尸体材料是研究的对象:我们使用了一个解剖的人右桡神经浅表感觉分支,直径2mm,孤立在前臂上,长约12厘米,因为它最符合所测试的NGC样本的直径。术后行超声成像,观察植入物及其与神经吻合处的回声特征。我们发现,基于其生物力学特性,混合NGC样本基本上适合用于外科实践,以确保周围神经缺损的生长和替换。然而,在对混合材料样品的生物相容性和功能特性进行比较临床前研究后,才能确定最佳的神经导片组成。混合生物材料制备的NGC样品的物理力学性能满足外科植入式神经导管的技术要求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Artificial nerve conduit for guiding peripheral nerve growth (cadaveric study)
At present, the search for effective ways of restoring peripheral nerves with anatomical damage continues. Autoplasty still remains the gold standard, which, however, is not without its drawbacks. The use of nerve implants for promoting directional axon growth is essential and promising.Objective: to study the biomechanical properties of laboratory samples of an artificial nerve conduit (NGC) made of hybrid biomaterials and to, on cadaveric material, assess the technical feasibility of using them in surgical practice to repair extended peripheral nerve defects.Material and methods. The objects of the study were three electrospun NGC samples: from synthetic material (polycaprolactone, PCL) and hybrid biomaterials (PCL + gelatin or PCL + collagen). The work compared the physical and mechanical properties of NGC: stiffness, plasticity, elasticity, brittleness, resistance to chemical attack, their ability to be impregnated with liquid media, permeability, possibility of making an anastomosis between the implant and the nerve during surgical procedure. Cadaveric material was the object of the study: we used a dissected superficial sensory branch of the human right radial nerve, 2 mm in diameter, isolated on the forearm, about 12 cm in length, because it most corresponded to the diameter of the NGC samples tested. After surgery, the echogenic features of the implants and their anastomoses with the nerve were assessed by ultrasound imaging.Results. It was found that hybrid NGC samples, based on their biomechanical properties, are fundamentally suitable for use in surgical practice, to ensure growth and replacement of a peripheral nerve defect. However, the best composition of a nerve guide can be established after comparative preclinical study of the biocompatible and functional properties of hybrid material samples.Conclusion. The physical and mechanical properties of the investigated NGC samples made of hybrid biomaterials meet the technical requirements for implantable nerve conduits for surgical application.
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