低强度脉冲超声联合关节腔内注射玻璃酸钠修复关节软骨缺损

发布时间：2018-10-29 18:18

【摘要】：背景:文献报道将低强度脉冲超声联合关节腔内注射玻璃酸钠运用于家兔关节软骨缺损修复中效果理想,能促进缺损部位愈合,但是该结论尚未得到进一步证实。目的:进一步验证低强度脉冲超声联合关节腔内注射玻璃钠在家兔关节软骨缺损中的修复效果。方法:60只家兔采用4 mL/kg浓度为20%乌拉坦溶液注射麻醉,在股骨踝部作直径为3 mm、深为3 mm的关节软骨缺损模型,根据处理方法分为模型对照组、玻璃酸钠组和观察组。模型对照组建模成功后不采取任何措施处理,玻璃酸钠组关节腔内注射玻璃酸钠修复,观察组在玻璃酸钠组基础上联合低强度脉冲超声修复。大体观察关节兔软骨缺损部位的形态;比较3组家兔修复后苏木精-伊红染色、番红O染色及Wakitani组织学评分。结果与结论:①大体观察:模型对照组修复5周后缺损直径缩小,表面不平整且低于周围组织;玻璃酸钠组修复5后缺损部位与正常软骨组织边界清晰;观察组修复5周后缺损部位完全修复;②观察组家兔修复后2,5周Wakitani组织学评分,低于玻璃酸钠组和模型对照组(P0.05);③观察组修复5周缺损部位细胞排列整齐;玻璃酸钠组修复5周后可见少许软骨区大量软骨样细胞;模型对照组修复后2,5周可见毛细心血管分布,排列不均匀;④观察组修复5周后缺损部位形态与正常软骨相似;玻璃酸钠组修复5周后深层蛋白多糖及软骨陷窝存在明显着色;模型对照组修复2,5周后深层染色偏白;⑤结果提示:低强度脉冲超声联合关节腔内注射玻璃钠在家兔关节软骨缺损中能取得理想修复效果。
[Abstract]:Background: Low-intensity pulsed ultrasound combined with intraarticular injection of sodium hyaluronate has been reported to be effective in repairing articular cartilage defects in rabbits, but this conclusion has not been further confirmed. Aim: to evaluate the effect of low intensity pulsed ultrasound combined with intraarticular injection of sodium glass in repairing articular cartilage defects in rabbits. Methods: 60 rabbits were anesthetized with 20% uratan solution for 4 mL/kg, and the articular cartilage defect model with 3 mm, diameter and 3 mm depth was made in the femur and malleolus. The rabbits were divided into model control group according to the treatment method. Sodium hyaluronate group and observation group. The model control group did not take any measures after successful modeling, sodium hyaluronate group was injected intraarticularly with sodium hyaluronate repair, the observation group in sodium hyaluronate group on the basis of low-intensity pulsed ultrasound repair. The morphology of cartilage defect in articular rabbits was observed and the hematoxylin eosin staining and Wakitani histological score were compared after repair in three groups. Results and conclusion: 1 gross observation: the diameter of defect in model control group was reduced after 5 weeks of repair, the surface was uneven and lower than that of surrounding tissue, and the boundary between defect site and normal cartilage tissue was clear in sodium hyaluronate group. The Wakitani histological score of the observation group was lower than that of the sodium hyaluronate group and the model control group (P0.05). A few chondroid cells were found in the cartilage region in the sodium hyaluronate group after 5 weeks of repair; in the model control group, capillary cardiovascular distribution was observed at 2 and 5 weeks after repair, and the arrangement was uneven. 4 in the observation group, the shape of the defect was similar to that of the normal cartilage after 5 weeks of repair. In sodium hyaluronate group, deep proteoglycan and cartilage lacunae were stained significantly after 5 weeks of repair, while in model control group, deep layer staining was white after 2 weeks of repair. The results suggest that low intensity pulsed ultrasound combined with intraarticular injection of sodium glass can achieve an ideal effect in repairing articular cartilage defects in rabbits.
【作者单位】：潍坊医学院附属益都中心医院潍坊市益都中心医院;
【基金】：山东省卫生厅基金资助项目(2015HZ026)~~
【分类号】：R684.3

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