背景：研究表明壳聚糖能够促进周围神经损伤修复，甲基泼尼松龙可改善损伤神经附近微环境，临床常用于中枢神经损伤急性期治疗。 目的：观察改性壳聚糖联合甲基泼尼松龙修复大鼠损伤坐骨神经的效果。 方法：将大鼠坐骨神经切断，立即显微吻合，分别于神经吻合周围注入改性壳聚糖，甲基泼尼松龙，改性壳聚糖+甲基泼尼松龙，生理盐水进行干预，并设假手术组进行对比。 结果与结论：在所有组中改性壳聚糖与甲基泼尼松龙联合治疗组展爪恢复时间最早(P<0.05)。建模后4，8，12周，与改性壳聚糖组、甲基泼尼松龙组及生理盐水对照组相比，改性壳聚糖与甲基泼尼松龙联合治疗组坐骨神经传导速度较快(P <0.05)，腓肠肌湿质量残存率下降较少(P <0.05)，腓肠肌细胞直径及截面积较大(P <0.05)。建模后12周，改性壳聚糖与甲基泼尼松龙联合治疗组通过吻合口的神经纤维显著增多，且直径大小、排列较为一致，神经变性较轻。结果证实，改性壳聚糖联合甲基泼尼松龙治疗有利于促进大鼠坐骨神经损伤的修复与再生。%BACKGROUND:Previous studies have shown that chitosan can promote the repair of peripheral nerve injury and methylprednisolone can improve the microenvironment around nerve injuries, which are commonly used in clinical treatment of acute central nervous system injury. OBJECTIVE:To observe the effects of modified chitosan and methylprednisolone combination on repair of sciatic nerve injury in rats. METHODS:The rat sciatic nerve was transected and microscopical y anastomosed immediately. Then, modified chitosan, methylprednisolone, methylprednisolone+modified chitosan, and saline were injected respectively around the anastomosis site, compared with the sham surgery group. RESULTS AND CONCLUSION:Compared with other groups, the combination group showed shorter claw extending reflex recovery time (P<0.05). Significant differences were found between the combination group and other groups in nerve conduction velocity, the remnant rate of gastrocnemius wet weight, the diameter and section area of gastrocnemius cells (P<0.05). The nerve fibers through the anastomotic site were significantly increased, with consistent thickness and arrangement and less neurodegeneration when observed 12 weeks after operation. In conclusion, the modified chitosan combined with methylprednisolone could significantly promote the sciatic nerve repair.
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