射频联合富血小板血浆修复半月板白区撕裂

发布时间：2018-06-18 20:39

本文选题：半月板 + 胫骨　；参考：《中国组织工程研究》2017年20期

【摘要】：背景:应用生物学方法有助于半月板白区损伤的修复,物理学方法亦能促进半月板的修复,两者联合使用的效果可能更好。目的:了解射频联合富血小板血浆对半月板白区撕裂修复的影响。方法:48只成年新西兰大白兔随机分为:单纯缝合组、射频组、富血小板血浆组、射频联合富血小板血浆组共4组。所有实验动物均建立半月板后角损伤模型。单纯缝合组仅行半月板间断褥式缝合;射频组在半月板缝合后给予射频治疗(20 W,45℃);富血小板血浆组在半月板缝合后关节内注射富血小板血浆凝胶;射频联合富血小板血浆组在半月板缝合后先予射频治疗,再在关节内注射富血小板血浆。术后3,12周时观察半月板大体形态及组织学变化,并检测转化生长因子、血管内皮生长因子、血小板衍生生长因子的表达。结果与结论:(1)术后12周标本显示单纯缝合组的半月板裂口仍然未见愈合;射频组和富血小板血浆组半月板创口部分填塞,射频联合富血小板血浆组半月板创口闭合,愈合组织内可见软骨细胞、胶原纤维排列较未愈合组织规则;射频联合富血小板血浆组与单纯缝合组之间愈合率有明显差异(P=0.003);(2)在3周时射频组、富血小板血浆组及射频联合富血小板血浆组血管内皮生长因子的表达较单纯缝合组明显增高,12周时明显下降。3周时各实验组,尤其是富血小板血浆组和射频联合富血小板血浆组,血小板衍生生长因子的表达增高。在12周时富血小板血浆组转化生长因子β1仍较高表达;(3)结果说明,射频联合富血小板血浆促进了半月板白区撕裂的修复,增加细胞增殖、促进细胞有丝分裂及血管形成是其机制之一。
[Abstract]:Background: the application of biological methods to the meniscus white area damage repair physical methods can also promote meniscus repair the combined use of the two may be more effective. Objective: to investigate the effect of radiofrequency (RF) combined with platelet-rich plasma on meniscus tear repair. Methods Forty-eight adult New Zealand white rabbits were randomly divided into 4 groups: simple suture group, radiofrequency group, platelet-rich plasma group and radiofrequency combined platelet-rich plasma group. The model of posterior horn injury of meniscus was established in all experimental animals. In simple suture group, only meniscus discontinuous puerperal suture was performed, radiofrequency group was treated with radiofrequency therapy after meniscus suture, platelet-rich plasma group was injected platelet-rich plasma gel into joints after meniscus suture. After meniscus suture, radiofrequency (RF) combined with platelet-rich plasma was given first and then intraarticularly injected platelet-rich plasma. The morphological and histological changes of meniscus were observed and the expression of transforming growth factor, vascular endothelial growth factor and platelet-derived growth factor were detected at 12 weeks after operation. Results and conclusion 12 weeks after operation, the meniscus fissure was still not healed in the simple suture group, the meniscus wound was partially filled in the radiofrequency group and platelet-rich plasma group, and the meniscus wound was closed in the radiofrequency and platelet-rich plasma group. Chondrocytes could be seen in the healing tissues, collagen fibers arranged more regularly than those of the unhealed tissues, and there was a significant difference in the healing rate between the radiofrequency and platelet-rich plasma groups and the simple suture group (P < 0.001. 3) at 3 weeks, the healing rate of the radiofrequency (RF) group was higher than that of the control group. The expression of vascular endothelial growth factor (VEGF) in platelet-rich plasma group and radiofrequency platelet rich plasma group was significantly higher than that in simple suture group. Especially in platelet-rich plasma group and radio-frequency combined platelet-rich plasma group, platelet-derived growth factor expression was increased. At 12 weeks, the expression of TGF- 尾 1 in platelet-rich plasma group was still high. The results showed that radiofrequency combined with platelet-rich plasma could promote the repair of meniscus laceration and increase cell proliferation. Promoting cell mitosis and angiogenesis is one of its mechanisms.
【作者单位】：江阴市人民医院骨科;江阴市人民医院中心实验室;
【基金】：江苏省卫生科研项目(Z201217) 江苏省科技计划项目(澄政科[2011]85号社-22)~~
【分类号】：R684

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