Objective To evaluate the effect of the injured peripheral nerve regeneration by using the method which dosage CH3 -VB12 continually and constantly in epineurium to the rabbit sciatic nerve transection model. Methods 18 male pigmented rabbits were randomly devided into 3 groups. Each group had six rabbits.Every pigmented rabbit's one side sciatic nerve was severed and sutured directly. The other side was not operated. Group A( Dosage in epineurium): Plant one conduit in the epineurium and pumping CH3 -VB12 through the conduit immediately. Group B (intramuscular inject group): After operation, intramuscular inject CH3 -VB12. Group C ( negative contrast group): didnt use any drugs after operation. The rabbits were sacrificed at the 6th week and the 12th week. Motor nerve conduction velocity ( MNCV), histological observation, axon video analysis and electron microscope observation were used to evaluate the effects. Results ( 1 ) MNCV in group A at the 6th weeks was(1.60±0.05)m·s-1;grouoB was (1.80±010)m·s-1;groupCwas(2.0 ±0.10)m· s-1. At l2th week,MNCV in group A was(1.30±O.12)m·s-1; group B was (1.50±0.13)m·s-1.Group C was (1.70±0.11)m·s-1. There were significant difference among group A, B and C ( P ＜ 0.05 ). (2)Histological observation: At the 6th week, there were some myelinated fibers in group A and a few in group B and seldom in group C. At the 12th week, there were more regeneration myelinated fibers in group A and some myelinated fibers in group B and a few in group C. (3)Axon video analysis: At the 6th week, group A was (6000 ±173), group B was (3000 ± 165) and group C was (1500 ±170). At the 12th week, group A was ( 13500 ± 169), group B was (6500 ± 167), group C was (2200 ± 160); there were significant difference among group A, B and C (P ＜0.05).(4) Transmission electron microscope: For group A, at the 6th week, the regenerative nerve myelin sheath's architecture was integrity. For group B, the regenerative nerve fiber had demyelinated and atrophia; For group C, the most regenerative nerve fibers demyelinated. At the 12th week, for group A, the regenerative nerve myelin sheath's architecture was good enough. For group B, the most regenerative nerve myelin sheath's architecture was complete but had atrophia problem. For group C, Schwann cell's architecture was near normal and some of the nerve myelin sheath had pyknosis problem. Conclusion The method which dosage CH3 -VB12 continually and constantly in epineurium to the rabbit sciatic nerve transection model is good for injured peripheral nerve regeneration.%目的:将神经外膜内持续恒量给予甲基维生素B(12)(CH3-VB(12))的治疗方法应用于兔坐骨神经断伤模型,评价其对周围神经损伤修复再生的影响.方法:取雄性青紫蓝兔30只,随机分为置管组、肌肉组和空白组,每组10只.将实验兔一侧下肢坐骨神经手术切断,用神经外膜吻合法恢复兔已横断坐骨神经的连续性.置管组为神经外膜内给药组,用微量泵将CH3-VB(12)以每只兔12.5μg·h(-1)的速度持续不间断泵入,24h泵入300μg,总药量为1500μg,5d后去除神经外膜内导管;肌肉组,每天每只兔1次自臀部肌肉注射CH3-VB(12)300μξ,共5d;空白组不用任何药物.各组分别于术后第6、12周进行手术侧坐骨神经肌电图检查、取材进行组织形态学光镜及电镜观察.结果:光镜下观察坐骨神经横断面有髓神经纤维轴突再生,有髓神经纤维轴突记数数量置管组＞肌肉组＞空白组;电镜下置管组再生的神经髓鞘结构完整,肌肉组和空白组再生的神经纤维有脱髓鞘改变及再生的神经纤维髓鞘有萎缩、固缩现象.结论:兔坐骨神经断伤模型神经外膜内持续恒量给予CH3-VB(12)可促进周围神经损伤修复再生,效果优于肌肉内给药.
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