医用EC耳脑胶粘合修复半月板裂伤

Effect of medical EC ear-brain glue on meniscus tear

目的:建立半月板裂伤动物模型,采用EC耳脑胶粘合裂伤的半月板,观察半月板裂伤的愈合情况,探讨EC耳脑胶在半月板裂伤治疗上的可行性。方法:实验于2004-01/07在锦州市中心医院动物实验中心及病理科、锦州医学院电镜室完成。健康成年新西兰兔20只,同体对照设计,将每只兔两侧膝关节外侧半月板制造裂伤,右膝外侧半月板为实验组,左膝外侧半月板为对照组,实验组用EC耳脑胶粘合裂伤,对照组裂伤不作任何处理。术后3,6,12,24周分批随机抽取动物5只,麻醉状态下处死,对裂伤半月板进行肉眼观察,光镜和电镜组织学观察。结果:①两组兔半月板肉眼观察:实验组3,6,12,24周各期半月板均无变形、变性。24周时修复组织与正常半月板组织相似,裂伤愈合。对照组3,6,12,24周各期半月板形态无明显变化。各期肉眼所见半月板裂伤仍有哆开。②两组兔半月板光镜组织学观察结果:实验组3周时镜下半月板裂伤粘合处修复组织主要为肉芽组织。6周时镜下半月板裂隙已被纤维结蒂组织及纤维软骨组织连接。24周时镜下半月板裂伤断端已被成熟的纤维软骨组织连结,愈合良好。对照组3,6,12,24周各期半月板裂伤光镜下均未见完全愈合,裂口分离。③两组兔半月板电镜组织学观察结果:同期电镜下观察也有同样结果。实验组3周时镜下半月板裂伤粘合处可见多种细胞成份,其中纤维软骨细胞少,胞核有变性。24周时镜下半月板裂伤处纤维软骨组织紧密连结,排列整齐、粗大的胶原纤维通过断端,裂伤缘消失。对照组3,6,12,24周各期半月板裂伤均未见完全愈合。两组兔24周时半月板裂伤愈合情况比较,差别有显著性意义(P<0.01)。结论:用EC耳脑胶粘合兔半月板的裂伤可使之愈合。此结果为临床半月板裂伤修复提供一基础研究依据。

AIM： To establish animal models of meniscus tear and observe the recuperation of meniscus tear after treated with medical EC ear-brain glue. METHODS： The experiment was completed in the Animal Experiment Center of Jinzhou Center Hospital, Department of Pathology and Department of Electron Microscope of Jinzhou Medical College from January to July 2004. Twenty adult healthy New Zealand rabbits, with controlled design on the same body, were injured on lateral meniscus tear of knee joint and divided into experimental group （lateral meniscus tear of right knee） and control group （lateral meniscus tear of left knee）. Rabbits in experimental group were treated with EC ear-brain glue, but rabbits in control group were not treated with any drug. Every 5 rabbits were randomly selected respectively in 3, 6, 12, 24 weeks after operation, and sacrificed under anesthesia. Meniscus tear was observed with macroscopy, histopathological changes under light microscope and electron microscope. RESULTS： ① Macroscopy of meniscus： Deformation and degeneration of meniscus were not observed in experimental group in 3, 6, 12 and 24 weeks. In the 24^th week, plerosis tissue was similar to normal meniscus tissue, and the tearing injury was healed. Form of meniscus was not changed in control group in 3, 6, 12 and 24 weeks. Compound fracture was still observed during each period. ② Histological results of meniscus under light microscope： In the 3^rd week, plerosis tissue of meniscus tear was shown as granulation tissue mainly, and in the 6^th week, crevice of meniscus was adhered to fibrous connective tissue and fibrous cartilage tissue. In the 24^th week, meniscus tear was adhered to mature fibrous cartilage tissue and recovered well. Complete healing of meniscus tear in control group was not observed under light microscope in 3, 6, 12 and 24 weeks, and the crack was separated. ③ Histological results of meniscus under electron microscope： The same results were observed during the same periods. Multiple Cell components were observed at adhering site of meniscus tear in experimental group in the 3^rd week. Fibrous cartilage tissue was rare and cellular nucleus was degenerated. In the 24^th week, fibrous cartilage tissue was adhered tightly and lined up in order. Thick collagen fiber passed through breaking end, and border of tearing was disappeared. Meniscus tear was not healed in control group in 3, 6, 12 and 24 weeks. Meniscus tears of rabbits in the two groups were recovered well in the 24^th week, and the difference was significant （P 〈 0.01）. CONCLUSION： Adhering meniscus tear with medical EC ear-brain glue is an effective met, had to repair harmed meniscus, which provides important theoretical basis for clinic.