Autologous nerve transplantation is currently recognized as the gold standard for treating seve re peripheral nerve injuries in clinical practice.Howeve r,challenges such as a limited supply of donors,complications in...Autologous nerve transplantation is currently recognized as the gold standard for treating seve re peripheral nerve injuries in clinical practice.Howeve r,challenges such as a limited supply of donors,complications in the donor area,and the formation of neuromas necessitate the optimization of existing transplantation strategies.Additionally,the development of new and promising repair methods is a critical issue in the field of peripheral nerve research.The purpose of this article is to compare the advantages and disadvantages of autologous,allogeneic,decellularized nerve grafts,and cell-composite graft,as well as to summarize the diffe rences in their prognostic factors and associated adve rse events.The length,diamete r,polarity,and sensory or motor origin of autografts all influence axonal regeneration.While pre-denaturation treatment can accele rate early regeneration,long-term functional outcomes of autografts do not show significant differences compared with fresh autologous grafts.For decellularized nerve grafts,defect length is identified as an independent risk factor,and the internal microenvironment(delayed angiogenesis,Schwann cell senescence,and reduced T-cell infiltration)is considered a key factor limiting long-segment regeneration.Additionally,the decellula rization process(whether chemical,physical,or supercritical CO_(2))affects the integrity of the extracellular matrix and the presence of immune residuals,which directly impacts axonal guidance and host integration.Common adve rse events following autograft transplantation include donor site numbness,neuromas,and scarring.In contrast,adverse events associated with decellularized nerve graft transplantation may present as inflammatory reactions,excessive scar prolife ration,and misalignment or reconnection of regenerating axons,which can lead to sensory-m otor cross-innervation.To mitigate these issues,combining decellularized nerve grafts with autologous Schwann cells,mesenchymal stem cells,or induced pluripotent stem cellderived cells may help bridge the gap with autografts.However,the fact that structural recovery does not necessarily lead to functional recovery needs further clarification.Future research should establish la rge animal models to replicate the limits of human regenerative capacity,use gene editing to enhance the phenotype and microenvironment of transplanted cells,and develop a mild combined decellularization process that maximizes the preservation of natural nerve grafts.Through multidimensional optimization,decellularized nerve grafts have the potential to ultimately re place autograft transplantation,enabling precise repair of individualized,long-segment,and complex nerve defects.展开更多
Avulsion injury of one or more spinal ventral roots induces a critical loss of motoneurons,followed by irreversible locomotor function impairment ranging from inadequate limb movement to complete paralysis of the limb...Avulsion injury of one or more spinal ventral roots induces a critical loss of motoneurons,followed by irreversible locomotor function impairment ranging from inadequate limb movement to complete paralysis of the limb.Recent surgical techniques facilitate improvement of limb function,but it remains to be determined exactly how many motoneurons are needed to survive and grow new axons to achieve sufficient muscle reinnervation.The aim of this study was to determine the minimum motoneuron quantity required to reinnervate the denervated skeletal muscles of the limb and produce a functionally satisfactory locomotor pattern.Since none of the commercially available methods and equipment were able to provide a quantifiable and in-depth analysis of the motor pattern of the entire hind limb,we have developed and applied a sensitive movement recording and analyzing system in order to determine the threshold of satisfactory functional reinnervation;we combined video-based footprint analysis and hind limb motion analysis to achieve a new and reliable assessment.Sprague-Dawley rats underwent a lumbar 4-5 ventral root avulsion,and their L4 ventral roots were subsequently reimplanted.The animals received different doses of riluzole treatment in order to rescue incremental numbers of the damaged motoneuron pool.We were able to assess one rear-view and six lateral parameters of the hind limb movement pattern by measuring specific joint angles,footprint,and gait parameters in single video frames.Four months after the operation,we performed Fast Blue retrograde tracing to label and count the reinnervating motoneurons.We then compared the numbers of reinnervating motoneurons and the functional improvement.Our results confirmed a strong relationship between functional restoration of the original movement pattern and morphological reinnervation;approximately 30%of the original motor pool was able to produce a useful locomotor pattern.We believe that our knowledge of the minimal motoneuron numbers required to reinnervate target muscles may help plan the segmental redistribution of the motoneuron pools for reinnervation surgeries.展开更多
Traditional nerve repair methods,such as autologous nerve grafting and allogeneic nerve grafting,face issues such as donor shortage,functional loss,and immune rejection.Decellularized extracellular matrix-based grafts...Traditional nerve repair methods,such as autologous nerve grafting and allogeneic nerve grafting,face issues such as donor shortage,functional loss,and immune rejection.Decellularized extracellular matrix-based grafts have emerged as highly promising alternatives,capable of uniquely recreating the natural neural mic roenvironment,promoting host cell remodeling,and ultimately enhancing functional neural regeneration.This review comprehensively analyzes the key mechanisms of peripheral nerve injury and regeneration,focusing on contemporary therapeutic strategies for key aspects such as axonal apoptosis inhibition,enhanced intrinsic regenerative capacity,construction of regenerative microenvironment,and prevention of target organ atrophy.Findings from this review has shown that decellularized extra cellular matrix grafts can promote the migration,prolife ration,and differentiation of nerve cells by providing physical suppo rt,chemical signals,and mechanical stability.Decellularized extracellular matrix grafts are mainly used as ne rve conduits,scaffolds,hydrogels,and3D printing inks.Decellularized extra cellular matrix grafts have demonstrated significant advantages in promoting nerve regeneration by regulating the prolife ration and differentiation of Schwann cells,improving the neural microenvironment,reducing inflammato ry responses,and promoting angiogenesis.Additionally,decellularized extracellular matrix grafts can se rve as drug carrie rs,enabling the controlled release of growth factors,which further enhances nerve regeneration.However,these grafts also have some limitations,including the presence of immunogenic residues,inadequate mechanical prope rties,inter-batch variability,and uncontrollable degradation rates.Future research should focus on optimizing the decellularization process,enhancing the mechanical prope rties of decellularized extracellular matrix grafts,reducing immunogenicity,improving biocompatibility and safety,and developing new composite mate rials.Furthermore,exploring their application potential in complex nerve injuries,such as diabetic neuropathy,is crucial to meet the needs of peripheral nerve regeneration and repair.展开更多
We have previously shown the success of polyethylene glycol fusion repair of segmental-loss peripheral nerve injuries in rats using freshly harvested,viable peripheral nerve allografts that can conduct action potentia...We have previously shown the success of polyethylene glycol fusion repair of segmental-loss peripheral nerve injuries in rats using freshly harvested,viable peripheral nerve allografts that can conduct action potentials.Because clinical application of polyethylene glycol fusion with viable peripheral nerve allografts demands pre-transplant donor tissue storage,we developed a protocol for ex vivo storage of rat sciatic nerves as viable peripheral nerve allografts,preserving many axons for up to 5 days.The current study evaluated the in vivo use of these stored viable peripheral nerve allografts.We hypothesized that stored viable peripheral nerve allografts with viable axons would enable successful in vivo repair of segmental-loss peripheral nerve injuries via polyethylene glycol-fusion.Polyethylene glycol-fused viable peripheral nerve allografts were classified as successful if they produced significantly improved locomotor recovery,as evaluated by the sciatic functional index,within 8 weeks post-repair.Many Sprague-Dawley and Lewis rats with successfully polyethylene glycol-fused viable peripheral nerve allografts had significantly improved sciatic functional index scores beginning at 5 weeks post-operatively.There was no significant difference in the efficiency and extent of successful polyethylene glycol fusion between stored and freshly harvested viable peripheral nerve allografts.In contrast,rats with non-fused negative control viable peripheral nerve allografts showed no recovery by 8 weeks post-operatively.Additional confirmatory outcome measures included in vivo compound action potentials and assessments of axon morphometry.These results suggest that viable peripheral nerve allografts can be stored and later used for successful polyethylene glycol fusion repair of segmental-loss peripheral nerve injuries.展开更多
Peripheral nerve injury causes severe neuroinflammation and has become a global medical challenge.Previous research has demonstrated that porcine decellularized nerve matrix hydrogel exhibits excellent biological prop...Peripheral nerve injury causes severe neuroinflammation and has become a global medical challenge.Previous research has demonstrated that porcine decellularized nerve matrix hydrogel exhibits excellent biological properties and tissue specificity,highlighting its potential as a biomedical material for the repair of severe peripheral nerve injury;however,its role in modulating neuroinflammation post-peripheral nerve injury remains unknown.Here,we aimed to characterize the anti-inflammatory properties of porcine decellularized nerve matrix hydrogel and their underlying molecular mechanisms.Using peripheral nerve injury model rats treated with porcine decellularized nerve matrix hydrogel,we evaluated structural and functional recovery,macrophage phenotype alteration,specific cytokine expression,and changes in related signaling molecules in vivo.Similar parameters were evaluated in vitro using monocyte/macrophage cell lines stimulated with lipopolysaccharide and cultured on porcine decellularized nerve matrix hydrogel-coated plates in complete medium.These comprehensive analyses revealed that porcine decellularized nerve matrix hydrogel attenuated the activation of excessive inflammation at the early stage of peripheral nerve injury and increased the proportion of the M2 subtype in monocytes/macrophages.Additionally,porcine decellularized nerve matrix hydrogel negatively regulated the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB axis both in vivo and in vitro.Our findings suggest that the efficacious anti-inflammatory properties of porcine decellularized nerve matrix hydrogel induce M2 macrophage polarization via suppression of the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB pathway,providing new insights into the therapeutic mechanism of porcine decellularized nerve matrix hydrogel in peripheral nerve injury.展开更多
文章研究周围神经损伤经同种异体神经移植后,添加载有他克莫司(FK506)的透明质酸(HA)对抑制神经吻合口周围瘢痕的影响。健康雄性体重200~250 g SD大鼠60只,20只作为神经供体,40只随机分4组:联合组、FK506组、HA组和对照组。取材:切取双...文章研究周围神经损伤经同种异体神经移植后,添加载有他克莫司(FK506)的透明质酸(HA)对抑制神经吻合口周围瘢痕的影响。健康雄性体重200~250 g SD大鼠60只,20只作为神经供体,40只随机分4组:联合组、FK506组、HA组和对照组。取材:切取双侧坐骨神经15 mm,并用Sondell脱细胞方法处理。移植神经:切取左侧坐骨神经造成10 mm缺损并移植神经,在每组SD大鼠神经吻合口分别注射药物。检测:Petersen评分、Masson染色、胶原及有髓神经纤维计数分析。利用统计学软件SPSS 25.0对数据进行处理分析。结果显示,联合组、FK506组和HA组中,神经吻合口与周围组织的黏连较轻,均优于对照组;联合组瘢痕最少,且有髓神经纤维数量多于其他3组。载有FK506的HA凝胶对瘢痕的抑制作用优于FK506和HA凝胶单独使用,可促进神经再生。展开更多
目的分析面肌痉挛患者行显微血管减压术的效果及术后听力障碍的影响因素。方法前瞻性选取2021年1月至2023年5月西安交通大学附属红会医院收治的108例面肌痉挛患者作为研究对象。按照随机数字表法将其分为对照组和观察组,每组各54例。两...目的分析面肌痉挛患者行显微血管减压术的效果及术后听力障碍的影响因素。方法前瞻性选取2021年1月至2023年5月西安交通大学附属红会医院收治的108例面肌痉挛患者作为研究对象。按照随机数字表法将其分为对照组和观察组,每组各54例。两组患者均行显微血管减压术,其中对照组采取传统竖切口,观察组采取微创直切口。比较两组手术预后和手术指标(术中出血量、手术时间、术后瘢痕长度),手术前后的疼痛情况[视觉模拟评分法(VAS)评分]、并发症发生情况。随访12个月,根据患者术后是否发生听力障碍,分为听力障碍组(n=14)和非听力障碍组(n=94)。收集两组患者临床资料,使用单因素分析和多因素Logistic回归分析对面肌痉挛患者行显微血管减压术后听力障碍的独立危险因素进行分析。结果两组患者均顺利完成手术,即刻治愈78例,延迟治愈30例。经随访12个月,均未见复发病例。观察组的手术时间、术后瘢痕长度分别为(62.14±3.51)min、(31.26±4.08)mL,均短于对照组[(76.53±5.12)min、(56.82±6.74)mL],术中出血量为(4.20±0.87)cm,少于对照组[(6.91±1.23)cm],差异均有统计学意义(P<0.05)。术后3 d,两组VAS评分均较术前明显降低,且观察组术后3 d VAS评分为(1.16±0.15)分,低于对照组[(2.23±0.28)分],差异有统计学意义(P<0.05)。两组均未见严重并发症发生,其中观察组并发症发生率为7.41%,低于对照组(20.37%),差异有统计学意义(P<0.05)。经单因素分析和多因素Logistic回归分析,合并高血压、责任血管为椎动脉、术中听神经物理性损伤、术中听神经滋养血管痉挛均是术后听力障碍的危险因素(OR=2.636,95%CI:1.025~7.552;OR=0.528,95%CI:0.013~5.021;OR=5.452,95%CI:1.245~24.578;OR=9.234,95%CI:1.206~68.763;P<0.05)。结论面肌痉挛患者行显微血管减压术效果较好,经微创直切口可进一步减轻手术创伤,而合并高血压、责任血管为椎动脉、术中听神经物理性损伤并滋养血管痉挛均是术后听力障碍的独立危险因素。展开更多
基金National Natural Science Foundation of China,No.82471412Science&Technology Innovation Talents Project of Henan Educational Committee,No.25HASTIT059+2 种基金Henan Academy of Medical Sciences Clinical Scientist Program,No.S20240069Young and Middle-aged Health Science and Technology Innovation Talent of Henan Province,No.JQRC2024014Henan Provincial Science&Technology Research and Development Program Joint Fund,No.232301420063(all to NZ)。
文摘Autologous nerve transplantation is currently recognized as the gold standard for treating seve re peripheral nerve injuries in clinical practice.Howeve r,challenges such as a limited supply of donors,complications in the donor area,and the formation of neuromas necessitate the optimization of existing transplantation strategies.Additionally,the development of new and promising repair methods is a critical issue in the field of peripheral nerve research.The purpose of this article is to compare the advantages and disadvantages of autologous,allogeneic,decellularized nerve grafts,and cell-composite graft,as well as to summarize the diffe rences in their prognostic factors and associated adve rse events.The length,diamete r,polarity,and sensory or motor origin of autografts all influence axonal regeneration.While pre-denaturation treatment can accele rate early regeneration,long-term functional outcomes of autografts do not show significant differences compared with fresh autologous grafts.For decellularized nerve grafts,defect length is identified as an independent risk factor,and the internal microenvironment(delayed angiogenesis,Schwann cell senescence,and reduced T-cell infiltration)is considered a key factor limiting long-segment regeneration.Additionally,the decellula rization process(whether chemical,physical,or supercritical CO_(2))affects the integrity of the extracellular matrix and the presence of immune residuals,which directly impacts axonal guidance and host integration.Common adve rse events following autograft transplantation include donor site numbness,neuromas,and scarring.In contrast,adverse events associated with decellularized nerve graft transplantation may present as inflammatory reactions,excessive scar prolife ration,and misalignment or reconnection of regenerating axons,which can lead to sensory-m otor cross-innervation.To mitigate these issues,combining decellularized nerve grafts with autologous Schwann cells,mesenchymal stem cells,or induced pluripotent stem cellderived cells may help bridge the gap with autografts.However,the fact that structural recovery does not necessarily lead to functional recovery needs further clarification.Future research should establish la rge animal models to replicate the limits of human regenerative capacity,use gene editing to enhance the phenotype and microenvironment of transplanted cells,and develop a mild combined decellularization process that maximizes the preservation of natural nerve grafts.Through multidimensional optimization,decellularized nerve grafts have the potential to ultimately re place autograft transplantation,enabling precise repair of individualized,long-segment,and complex nerve defects.
文摘Avulsion injury of one or more spinal ventral roots induces a critical loss of motoneurons,followed by irreversible locomotor function impairment ranging from inadequate limb movement to complete paralysis of the limb.Recent surgical techniques facilitate improvement of limb function,but it remains to be determined exactly how many motoneurons are needed to survive and grow new axons to achieve sufficient muscle reinnervation.The aim of this study was to determine the minimum motoneuron quantity required to reinnervate the denervated skeletal muscles of the limb and produce a functionally satisfactory locomotor pattern.Since none of the commercially available methods and equipment were able to provide a quantifiable and in-depth analysis of the motor pattern of the entire hind limb,we have developed and applied a sensitive movement recording and analyzing system in order to determine the threshold of satisfactory functional reinnervation;we combined video-based footprint analysis and hind limb motion analysis to achieve a new and reliable assessment.Sprague-Dawley rats underwent a lumbar 4-5 ventral root avulsion,and their L4 ventral roots were subsequently reimplanted.The animals received different doses of riluzole treatment in order to rescue incremental numbers of the damaged motoneuron pool.We were able to assess one rear-view and six lateral parameters of the hind limb movement pattern by measuring specific joint angles,footprint,and gait parameters in single video frames.Four months after the operation,we performed Fast Blue retrograde tracing to label and count the reinnervating motoneurons.We then compared the numbers of reinnervating motoneurons and the functional improvement.Our results confirmed a strong relationship between functional restoration of the original movement pattern and morphological reinnervation;approximately 30%of the original motor pool was able to produce a useful locomotor pattern.We believe that our knowledge of the minimal motoneuron numbers required to reinnervate target muscles may help plan the segmental redistribution of the motoneuron pools for reinnervation surgeries.
基金National Natural Science Foundation of China,No.32130060,No.81901256Jiangsu College Students Innovation and En trepreneurship Training Program,No.202310304120Y,No.202313993004Y2024 Medical Research Project by the Jiangsu Commission of Health,No.M2024009。
文摘Traditional nerve repair methods,such as autologous nerve grafting and allogeneic nerve grafting,face issues such as donor shortage,functional loss,and immune rejection.Decellularized extracellular matrix-based grafts have emerged as highly promising alternatives,capable of uniquely recreating the natural neural mic roenvironment,promoting host cell remodeling,and ultimately enhancing functional neural regeneration.This review comprehensively analyzes the key mechanisms of peripheral nerve injury and regeneration,focusing on contemporary therapeutic strategies for key aspects such as axonal apoptosis inhibition,enhanced intrinsic regenerative capacity,construction of regenerative microenvironment,and prevention of target organ atrophy.Findings from this review has shown that decellularized extra cellular matrix grafts can promote the migration,prolife ration,and differentiation of nerve cells by providing physical suppo rt,chemical signals,and mechanical stability.Decellularized extracellular matrix grafts are mainly used as ne rve conduits,scaffolds,hydrogels,and3D printing inks.Decellularized extra cellular matrix grafts have demonstrated significant advantages in promoting nerve regeneration by regulating the prolife ration and differentiation of Schwann cells,improving the neural microenvironment,reducing inflammato ry responses,and promoting angiogenesis.Additionally,decellularized extracellular matrix grafts can se rve as drug carrie rs,enabling the controlled release of growth factors,which further enhances nerve regeneration.However,these grafts also have some limitations,including the presence of immunogenic residues,inadequate mechanical prope rties,inter-batch variability,and uncontrollable degradation rates.Future research should focus on optimizing the decellularization process,enhancing the mechanical prope rties of decellularized extracellular matrix grafts,reducing immunogenicity,improving biocompatibility and safety,and developing new composite mate rials.Furthermore,exploring their application potential in complex nerve injuries,such as diabetic neuropathy,is crucial to meet the needs of peripheral nerve regeneration and repair.
基金National Institutes of Health(NIH)R01-NS128086 grant(to GDB and JSB)Lone Star Paralysis Foundation(to GDB).
文摘We have previously shown the success of polyethylene glycol fusion repair of segmental-loss peripheral nerve injuries in rats using freshly harvested,viable peripheral nerve allografts that can conduct action potentials.Because clinical application of polyethylene glycol fusion with viable peripheral nerve allografts demands pre-transplant donor tissue storage,we developed a protocol for ex vivo storage of rat sciatic nerves as viable peripheral nerve allografts,preserving many axons for up to 5 days.The current study evaluated the in vivo use of these stored viable peripheral nerve allografts.We hypothesized that stored viable peripheral nerve allografts with viable axons would enable successful in vivo repair of segmental-loss peripheral nerve injuries via polyethylene glycol-fusion.Polyethylene glycol-fused viable peripheral nerve allografts were classified as successful if they produced significantly improved locomotor recovery,as evaluated by the sciatic functional index,within 8 weeks post-repair.Many Sprague-Dawley and Lewis rats with successfully polyethylene glycol-fused viable peripheral nerve allografts had significantly improved sciatic functional index scores beginning at 5 weeks post-operatively.There was no significant difference in the efficiency and extent of successful polyethylene glycol fusion between stored and freshly harvested viable peripheral nerve allografts.In contrast,rats with non-fused negative control viable peripheral nerve allografts showed no recovery by 8 weeks post-operatively.Additional confirmatory outcome measures included in vivo compound action potentials and assessments of axon morphometry.These results suggest that viable peripheral nerve allografts can be stored and later used for successful polyethylene glycol fusion repair of segmental-loss peripheral nerve injuries.
基金supported by the Shenzhen Hong Kong Joint Funding Project,No.SGDX20230116093645007(to LY)the Shenzhen Science and Technology Innovation Committee International Cooperation Project,No.GJHZ20200731095608025(to LY)+7 种基金Shenzhen Development and Reform Commission’s Intelligent Diagnosis,Treatment and Prevention of Adolescent Spinal Health Public Service Platform,No.S2002Q84500835(to LY)Shenzhen Medical Research Fund,No.B2303005(to LY)Team-based Medical Science Research Program,No.2024YZZ02(to LY)Zhejiang Provincial Natural Science Foundation of China,No.LWQ20H170001(to RL)Basic Research Project of Shenzhen Science and Technology from Shenzhen Science and Technology Innovation Commission,No.JCYJ20210324103010029(to BY)Shenzhen Second People’s Hospital Clinical Research Fund of Guangdong Province High-level Hospital Construction Project,Nos.2023yjlcyj029(to BY),2023yjlcyj021(to LL)Guangdong Basic and Applied Basic Research Foundation,No.2022A1515110679(to LL)China Postdoctoral Science Foundation,No.2022M722203(to GL).
文摘Peripheral nerve injury causes severe neuroinflammation and has become a global medical challenge.Previous research has demonstrated that porcine decellularized nerve matrix hydrogel exhibits excellent biological properties and tissue specificity,highlighting its potential as a biomedical material for the repair of severe peripheral nerve injury;however,its role in modulating neuroinflammation post-peripheral nerve injury remains unknown.Here,we aimed to characterize the anti-inflammatory properties of porcine decellularized nerve matrix hydrogel and their underlying molecular mechanisms.Using peripheral nerve injury model rats treated with porcine decellularized nerve matrix hydrogel,we evaluated structural and functional recovery,macrophage phenotype alteration,specific cytokine expression,and changes in related signaling molecules in vivo.Similar parameters were evaluated in vitro using monocyte/macrophage cell lines stimulated with lipopolysaccharide and cultured on porcine decellularized nerve matrix hydrogel-coated plates in complete medium.These comprehensive analyses revealed that porcine decellularized nerve matrix hydrogel attenuated the activation of excessive inflammation at the early stage of peripheral nerve injury and increased the proportion of the M2 subtype in monocytes/macrophages.Additionally,porcine decellularized nerve matrix hydrogel negatively regulated the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB axis both in vivo and in vitro.Our findings suggest that the efficacious anti-inflammatory properties of porcine decellularized nerve matrix hydrogel induce M2 macrophage polarization via suppression of the Toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-κB pathway,providing new insights into the therapeutic mechanism of porcine decellularized nerve matrix hydrogel in peripheral nerve injury.
文摘目的分析面肌痉挛患者行显微血管减压术的效果及术后听力障碍的影响因素。方法前瞻性选取2021年1月至2023年5月西安交通大学附属红会医院收治的108例面肌痉挛患者作为研究对象。按照随机数字表法将其分为对照组和观察组,每组各54例。两组患者均行显微血管减压术,其中对照组采取传统竖切口,观察组采取微创直切口。比较两组手术预后和手术指标(术中出血量、手术时间、术后瘢痕长度),手术前后的疼痛情况[视觉模拟评分法(VAS)评分]、并发症发生情况。随访12个月,根据患者术后是否发生听力障碍,分为听力障碍组(n=14)和非听力障碍组(n=94)。收集两组患者临床资料,使用单因素分析和多因素Logistic回归分析对面肌痉挛患者行显微血管减压术后听力障碍的独立危险因素进行分析。结果两组患者均顺利完成手术,即刻治愈78例,延迟治愈30例。经随访12个月,均未见复发病例。观察组的手术时间、术后瘢痕长度分别为(62.14±3.51)min、(31.26±4.08)mL,均短于对照组[(76.53±5.12)min、(56.82±6.74)mL],术中出血量为(4.20±0.87)cm,少于对照组[(6.91±1.23)cm],差异均有统计学意义(P<0.05)。术后3 d,两组VAS评分均较术前明显降低,且观察组术后3 d VAS评分为(1.16±0.15)分,低于对照组[(2.23±0.28)分],差异有统计学意义(P<0.05)。两组均未见严重并发症发生,其中观察组并发症发生率为7.41%,低于对照组(20.37%),差异有统计学意义(P<0.05)。经单因素分析和多因素Logistic回归分析,合并高血压、责任血管为椎动脉、术中听神经物理性损伤、术中听神经滋养血管痉挛均是术后听力障碍的危险因素(OR=2.636,95%CI:1.025~7.552;OR=0.528,95%CI:0.013~5.021;OR=5.452,95%CI:1.245~24.578;OR=9.234,95%CI:1.206~68.763;P<0.05)。结论面肌痉挛患者行显微血管减压术效果较好,经微创直切口可进一步减轻手术创伤,而合并高血压、责任血管为椎动脉、术中听神经物理性损伤并滋养血管痉挛均是术后听力障碍的独立危险因素。
