壳聚糖/PLGA乳化膜预防鸡趾屈肌腱粘连的实验研究

Experimental study of chitosan/PLGA emulsive membrane on postoperative adhesions in chicken flexor tendon

目的研究壳聚糖/PLGA乳化膜预防鸡趾鞘管区屈肌腱粘连的效果。方法雌性成年种禽45只,随机分成3组,每组15只。A组为对照组,B组为PLGA膜组,C组为壳聚糖/PLGA乳化膜组。将左足三、四趾趾浅屈肌腱切除,横断趾深屈肌腱,作改良Kessler法缝合,B、C两组分别局部包裹PLGA膜及壳聚糖/PLGA乳化膜。术后2、4、6周取材,分别行大体观察、组织学检查和生物力学测定。结果组织学检查显示:3组肌腱愈合进程无明显差异,B组局部白细胞浸润较其他两组明显。两实验组缝合处粘连评分及将肌腱牵出鞘管所需最大力量与对照组相比差异有显著统计学意义(P<0.05)。结论局部应用PLGA膜及壳聚糖/PLGA乳化膜均能减轻肌腱术后粘连,前者局部炎症反应较明显,而后者无明显炎症反应发生,因而壳聚糖/PLGA乳化膜是一种较理想的预防肌腱粘连的可降解材料。

Objective To study the effect of chitosan/PLGA emulsive membrane on postoperative adhesions in chicken flexor tendon. Methods A total of 45 chickens were divided into 3 groups randomly, 15 for each group.The chickens of group A enrolled as controls, the deep flexor tendon of the third and forth toes in zone II were cut and sutured with a single 6-0 nylon stitch by a modified Kessler technique, encapsulated PLGA membrane and chitosan/PLGA emulsive membrane in groups B, C respectively. Five chickens from each group were sacrified at 2,4,6 weeks after operation.The results were evaluated grossly, histologically and biomechanically.Each operated tendon was compared to the corresponding tendon in the contralateral, nonoperated foot.This approach eliminated the effect of normal restricting mechanisms eg. vincula and mesothenon.All results were input into a computer and analyzed with multiple-range test.Significance level was 0.05. Results The gross appearance and biomechanical data of groups B, C were both superior to those of group A （P 〈 0.05 ）.The healing process of 3 groups did not appear any difference,but the white blood cells in group B were more apparent than groups A and C. Conclusion It is demonstrated that postoperative adhesion could be controlled by using PLGA membrane and chitosan/PLGA membrane,the inflammatory reaction of former is more significant.Thus it is an ideal approach for prevention of tendon adhesions by using chitosan/PLGA emulsive membrane.