自体脂肪颗粒纯化移植预防肌腱粘连的临床研究

Clinical Study of Autogenous Fat Particle Purify Transplant for Prevention of Tendon Adhesion

目的 探讨预防术后肌腱粘连更为有效的方法和材料。方法 2003年1月至2005年1月间，我们对符合研究条件的70例82条指屈肌腱断裂伤，分别采用单纯缝合术和缝合后自体脂肪颗粒纯化移植两种方法治疗，进行对比研究。结果 随访2～16个月，平均6．5个月，用TAM系统评定法来判定肌腱缝合后的功能恢复情况。采用自体脂肪颗粒纯化移植治疗组46条肌腱，优22条，良18条，中6条，差0条，优良率86．96％；单纯肌腱缝合治疗组36条肌腱，优6条，良14条，中12条，差4条，优良率55．56％。两组差异有统计学意义（P〈0．001）。结论 纯化脂肪颗粒是预防肌腱粘连的理想材料，有良好的生物相容性。具有促进肌腱愈合、防止或减轻术后粘连、改善肌腱滑动的作用。

Objective To investigate the material and a better method for prevention and treatment of tendon adhesion. Methods From Jan 2003 to Jan 2005, 82 tendons in 70 cases were repaired by operation. We applicacated only tendinosuture for control group and autogenous fat particle purify transplant during the primary tendon repair operation. Results All patients were followed up for 2 to 16 months with an average of 6.5 months. According to TAM standard： 48 tendons in autogenous fat particle purify transplant group, 22 tendons were excellent, 18 good, 6 fair and no poor, the rate of excellent and good was 86.96% ; 36 tendons in only tendinosuture group, 6 tendons were excellent, 14 good, 12 fair and 4 poor, the rate of excellent and good was 55.56%. There was a signficant difference （P〈0. 001）. Conclusion Purifiing fat particle is an idea choice for prevention and treatment of tendon adhesion. It can promote tendon healing effectively, prevent or reduce tendon adhesion and improve tendon excursion.