Clincal effects of nerve growth factor gradient release system on treatment of peripheral nerve injuries / 中华显微外科杂志

ABSTRACT

Objective To prepare nerve growth factor gradient release system,and explore the promotion of the clinical effects of peripheral nerve regeneration.Methods All 57 cases with peripheral nerve injuries were treated with emergency nerve repair from July 2010 to August 2012,a nerve repair,with meanwhile randomly were divided into group A (19 cases),group B (19 cases) and group C (19 cases).The NGF was used to partial release by using the homemade gradient release system in group A,the same amount of NGF was partial injeced to Gelatin sponge surrounding peripheral nerve in group B.The NGF wasn't injected in group C.All patients respectively underwent neurophysiological examination after 4 weeks and 8 weeks.Comparising with the somatosensory evoked potentials (SEP) and muscle action potential (MAP) between different groups,meanwhile analyzing nerve conduction velocity (NCV).The sensory and motor function evaluation score of BMRC were performed after 24 weeks.Results The peak latency of the SEP after 4 weeks in A,B and C groups were (34.80 ± 3.45) ms,(42.85 ± 2.58) ms,and (51.05 ±3.652) ms,respectively; the volatility were (10.673 ± 2.35) μV,(6.30 ± 1.22) μV,and (4.10 ±0.83) μV,the peak latency of the MAP after 4 weeks in A,B,C groups were(5.29 ±0.82) ms,(7.63 ± 1.35)ms,and (9.98 ± 1.15) ms,the volatility were (485.75 ±65.83) μV,(262.510 ±59.90) μV,and (185.64 ±38.35) μV,the NCV were (25.50 ±3.65) m/s,(19.80±2.35) m/s,and (15.50 ±2.61) m/s.The peak latency of the SEP after 8 weeks in A,B,C groups were (24.68 ±4.50) ms,(31.08 ±4.24) ms,and (39.25 ±4.83) ms,the volatility were (21.22 ± 4.63) μV,(13.68 ± 4.14) μV,and (8.90 ± 1.25) μV.The peak latency of the MAP after 8 weeks in A,B,C groups were (4.71 ±0.35) ms,(6.10±1.54) ms,and (8.86±0.75) ms,the volatility were (839.81 ± 111.07) μv,(512.25 ±46.82) μv,and (312.65 ±47.52) μv,the NCV were (26.24±3.22) m/s,(21.23 ±2.40) m/s,and (16.34 ±2.55) m/s.Compared with the group C,the peak latency of the SEP,MAP was shortened significantly and the Volatility was increased significantly in group A and B,the NCV was faster significantly in group A and B (P ＜ 0.05).Compared with the group B,the peak latency of the SEP,MAP was shortened significantly and the Volatility was increased significantly in group A,the NCV was faster significantly in group A (P ＜ 0.05).The good rate of the A,B,C groups in BMRC sensory function score were 78.95％,63.15％ and 52.63％ respectively.The good rate in BMRC motor function score were 84.21％,68.42％and 47.37％ respectively.The group A and B were higher than group C,and the good rate of group A was higher than group B(P ＜ 0.05).Conclusion The nerve growth factor gradient release system is safe and effective for early treatment of peripheral nerve injuries.