新鲜羊膜与脱细胞羊膜修复腱鞘缺损预防肌腱粘连

发布时间：2018-11-15 10:37

【摘要】：背景:羊膜独有的结构可阻止某些物质通过,能保证包裹内组织正常营养供应,而且具有抗粘连、组织相容性好、炎性反应轻、纤维包裹少及可降解等特性。目的:比较新鲜羊膜及脱细胞羊膜修复腱鞘缺损,预防肌腱粘连和促进肌腱愈合的作用。方法:取60只雄性来亨鸡,制作双足第三足趾制备肌腱及腱鞘损伤模型,随机分为3组修复,新鲜羊膜组采用新鲜人羊膜修复腱鞘缺损,脱细胞羊膜组采用人脱细胞羊膜修复腱鞘缺损,对照组不做腱鞘修复。修复后进行第三足趾组织学观察及生物力学测试。结果与结论:①组织学观察:修复后2周,3组均存在充血水肿及炎症反应,新鲜羊膜组最轻,对照组最严重,3组水肿及炎症反应随时间延长逐渐减轻。修复12周,各组假鞘较修复后4周明显成熟,新鲜羊膜组及脱细胞羊膜组假鞘表面细胞致密层状排列整齐,表面光滑;对照组假鞘表面细胞排列紊乱,结构松散,可见表面纤维组织突出假鞘表面;②生物力学测试:脱细胞羊膜组、新鲜羊膜组修复后4,8,12周的肌腱滑动距离均大于对照组(P0.05),前2组间比较差异无显著性意义;脱细胞羊膜组、新鲜羊膜组修复后4,8周的肌腱最大拉伸断裂强度高于对照组(P0.05),且新鲜羊膜组高于脱细胞羊膜组(P0.05),3组修复后12周的肌腱最大拉伸断裂强度无差异;③结果表明:新鲜羊膜和脱细胞羊膜均可用于重建腱鞘缺损,预防肌腱粘连,新鲜羊膜在促进早期肌腱愈合方面优于脱细胞羊膜。
[Abstract]:Background: the unique structure of amniotic membrane can prevent certain substances from passing through and can guarantee the normal nutrition supply of the surrounding tissue. It also has the characteristics of anti-adhesion, good histocompatibility, light inflammatory reaction, less fiber encapsulation and degradability. Aim: to compare the effects of fresh amniotic membrane and acellular amniotic membrane in repairing tendon sheath defect, preventing tendon adhesion and promoting tendon healing. Methods: 60 male Leghorn chickens were used to make the injury model of tendon and tendon sheath in the third toe of the foot. The fresh amniotic membrane was used to repair the defect of tendon sheath in the fresh amniotic membrane group. Human acellular amniotic membrane was used to repair the defect of tendon sheath in the acellular amniotic membrane group, while the control group was not repaired with tendon sheath. Histological observation and biomechanical test of the third toe were performed after repair. Results and conclusion: 1 histological observation: 2 weeks after repair, there were hyperemia edema and inflammation in all the three groups, the fresh amniotic membrane group was the lightest, the control group was the most serious, and the edema and inflammatory reaction in the three groups gradually decreased with the time prolonging. After 12 weeks of repair, the pseudosheath of each group was obviously mature compared with that of the 4th week after repair. The surface of the false sheath in fresh amniotic membrane group and acellular amniotic membrane group was arranged neatly and neatly, and the surface was smooth. In the control group, the surface cells of the pseudosheath were disordered and the structure was loose, and the fibrous tissue of the surface could protrude the surface of the false sheath. 2Biomechanical test: the tendon gliding distance in the acellular amniotic membrane group and fresh amniotic membrane group at 12 weeks after repair was higher than that in the control group (P0.05), but there was no significant difference between the first two groups. In the acellular amniotic membrane group, the maximum tensile breaking strength of the tendon in the fresh amniotic membrane group was higher than that in the control group at 4 weeks after repair (P0.05), and that in the fresh amniotic membrane group was higher than that in the acellular amniotic membrane group (P0.05). There was no difference in maximum tensile strength of tendon 12 weeks after repair in the three groups. The results showed that fresh amniotic membrane and acellular amniotic membrane could be used to reconstruct tendon sheath defect and prevent tendon adhesion. Fresh amniotic membrane was superior to acellular amniotic membrane in promoting early tendon healing.
【作者单位】：河北医科大学第三医院手外科河北省骨科生物力学重点实验室;
【基金】：河北省医学科学研究重点课题计划(ZL20140210)~~
【分类号】：R318.08;R687

【相似文献】