海水浸泡爆炸伤关节滑膜修复的研究

Repair of Seawater Immersed Synovial Member of Joint After Blast Injury

目的观察海水浸泡爆炸伤关节滑膜组织学变化,了解关节液对哌啶醇氮氧自由基(TEMPO)的作用。方法制作爆炸伤模型。随机分组,关节内注入TEMPO溶液0.5ml(浓度10-4mol/L),电子自旋共振仪(ESR)检测TEMPO,同时取滑膜作组织观察。结果1个月时滑膜组织仍肿胀,漏出的红细胞未完全吸收,关节液清除TEMPO能力低;2个月时滑膜组织形态改善,细胞数尚少,关节液清除TEMPO能力有提高;3个月时滑膜组织修复已近于正常,关节液清除TEMPO能力与正常关节液相比,5min和1h时差异不明显,2h和3h时差异明显。结论海水浸泡的兔关节爆炸伤经3个月修复,滑膜组织组织学观察已近于正常;关节液对外源性氮氧自由基清除能力短期正常,2h和3h时仍低于正常,且差异显著。

Objective To observe the histological changes of synovial member of joint in seawater immersed explosive wound and to study the effect of synovial fluid on 2, 2, 6, 6 - tetramethylpiperidinyl - 1 - oxy free radical （TEMPO）. Methods The model of explosive wound was established and grouped randomly. TEMPO of 0.5 ml with concentration of 10^-4 mol/L was injected into the knee joint. The TEMPO was detected by electron spin resonance （ESR）. The synovial member was histologically observed. Results In 1 month, the synovial member tissue was still swelling; the leaked erythrocytes were not absorbed completely; the ability of joint fluid for removal of TEMPO was reduced. In 2 months, the morphology of synovial member was improved though there was no er/ough cell number; the ability of join fluid for removal of TEMPO was increased, although it was still lower than that in the control group. In 3 months, the synovial member was almost the normal tissue compared with the control group. There was no significant difference in the capability of joint fluid for removal of TEMPO between 5 minutes and 1 hour while there was significant difference between 2 hours and 3 hours. Conclusion The seawater immersed explosive wounds of rabbits undergo 3 months＇ repair and the synovial member tissues are near to normal tissue by histological observation. The capacity of joint fluid for removal of TEMPO is normal in short time, but it is lower than the normal joint fluid with the significant difference between 2 hours and 3 hours.