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Peripheral nerve breaking especially high injury clinical application of traditional nerve anastomosis method (simple adventitial suture perineurium suture, outer membrane perineurium suture) often occurs nerve bundles wrong then, escape and anastomotic neuroma formation seriously affect the recovery of neurological function. Peripheral nerve selective regeneration theory proposed provides a theoretical basis for small gap anastomosis repair of peripheral nerve transection. Many scholars application of natural or synthetic nerve conduit bridging peripheral nerve rupture, but there is need to sacrifice the lack of autologous tissue graft source is limited, for the District function defects. Some scholars application of autologous fracture of the epineurium bridge repair peripheral nerve, epineurium anastomosis in the small gap, this may still lead to the escape of neuroma formation, nerve bundles and nerve function recovery difference. Which some scholars reported the flip or glide autologous epineurial small gap anastomosis repair of peripheral nerve transection, but flip or glide autologous epineurial destroyed epineurial blood supply, and make it part of the normal exposure to nerve bundles, This may affect nerve regeneration and functional recovery. Objective: To cut the socket autologous epineurium small gap anastomosis repair of peripheral nerve rupture, and to explore the feasibility and superiority of nerve regeneration chamber built by this new approach. Methods: Animal experiments: March age Sprague-Dawley rats 40, weighing about 250g, were randomly divided into 2 groups of 20 each. The midpoint between the sciatic nerve pelvic exports and tibiofibular nerve bifurcation of the sciatic nerve in the rat lower limb sciatic nerve after revealing cut sciatic nerve. The experimental group (20): cut the socket autologous the epineurium small gap anastomosis (2mm nerve gap), and the control group (20): The epineurium situ anastomosis. 2, 4, 6, 8, 10, 12, 14, and 16 weeks after surgery, respectively, two animals were removed from the two groups, the general observation of experimental animal limb recovery of spontaneous activity and ulcer healing; naked eye under the microscope regeneration chamber and anastomosis at the general form of HE stained toluene of ammonia Blue and lead nitrate, respectively, in the light microscope and electron microscope nerve fiber regeneration of the experimental group and the control group were observed. Results: 1. Postoperative experimental group and the control group of rats were paralyzed the experimental rats postoperative recovery autonomic activity than the control group, the experimental group, ulcer healing faster than the control group. 2. Microscopy naked eye nerve the small gap adventitia no collapse, no shift, consistent with the port and the surrounding tissue adhesions light, no neuroma formation; epineurium anastomosis of the control group with the surrounding tissue adhesion heavier, neuroma formation. Observed small gap site of the experimental group significantly reduced connective tissue proliferation, regeneration of nerve bundles orderly arranged in strips, connective tissue proliferation is not obvious; the control group at the anastomosis nerve disordered arrangement were curled 3.HE staining optical microscope connective tissue proliferation increased significantly. TEM observations regenerating nerve myelin lamellar distal small gap of the experimental group was arranged in a concentric dense, neat, Schwann cell proliferation significantly; disordered arrangement of the nerve fibers of the control group, regenerated nerve myelin lamellar arranged loose not neat. 5. Statistical analysis showed that the count of myelinated nerve fibers found in each group units horizons number of myelinated nerve fibers in the experimental group gt; control group and the experimental group of nerve fiber regeneration recovery rate higher than the control group, the differences were statistically significant (P lt; 0.05). Conclusion: 1 The experiments confirmed through cut sockets from body epineurium small gap anastomosis is feasible to build the nerve regeneration chamber, is a new small gap repair of peripheral nerve transection anastomosis. The method without additional drawn to avoid donor site dysfunction, applications at the same time have a good blood supply autologous epineurial avoid rejection due to the application of synthetic biological or non-biological conduit, to build this new approach nerve regeneration chamber is relatively closed and complete epineurium anastomosis and backward is not a small gap with nerve stump is not in the same plane, which avoids the nerve bundles wrong then, escape and epineurium anastomosis neuroma formation, provides a good micro-environment for the selective regeneration of peripheral nerve.
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