人发角蛋白材料人工腱的实验研究与临床应用

Experimental Study of Human Hair Keratin Artificial Tendon and Its Clinical Application

目的：探讨以人发为材料经特殊促腱化处理，置入生物体内可被机体吸收，同时转化为机体自体肌腱的演变过程．方法：实验用新西兰大白兔２０只，兔两下肢脱毛后皮肤消毒．以１％普鲁卡因５ｍｌ局部麻醉下，将跟腱切除３ｃｍ，造成缺损，以直径３ｍｍ的人发角蛋白材料（代号１０９ＨＨ）人工腱代替缺损，上下断端进行编织缝合，作为实验侧；将右后肢以等同粗细碳纤维人工腱进行编织缝合，作为对照组．分别于术后６、８、１２周取材，光镜和电镜下观察人工腱的结构变化．在此基础上应用于临床１１８例观察其疗效．结果：１０９ＨＨ人工腱在植入兔体６周时被胶原纤维包绕分割，毛发周围巨噬细胞浸润，有较多胶原纤维，第８周时１０９ＨＨ人工腱周围出现大量胶原纤维，毛发大部被吸收胶原纤维化；第１２周时１０９ＨＨ人工腱完全吸收，被成纤维细胞及胶原纤维取代．对照组中碳纤维腱完全无变化．电镜下见１０９ＨＨ人工腱的，毛发丝解聚、吸收，并有大量粗面内质网发达的成纤维细胞和胶原纤维．１２周后完全吸收１０９ＨＨ人工腱，成纤维细胞转化成纤维细胞．临床应用１０９ＨＨ人工腱１１８例，伤口红肿、Ⅰ期愈合，滑动好，术后３～６周能负重．总优良率为９６％．结论：１０９ＨＨ人工腱置入体无排拆反应?

Aim: To explore the process of implantation of an artificial tendon which is made of human hair keratin, named 109HH artificial tendon, and its possible clinical application. Methods: Twenty New Zealand rabbits weighing 2.5 kg averagely were defected by cutting achilles tendon in 3 mm. 109HH artifical tendon of 3 mm in diameter was implanted. Examples were taken at 6, 8, 10 and 12 weeks after implantation, and observed under electric microscope. Immunology, histology and biomechanics were used. Results: At 6 week after implantation 109HH artificial tendon was surrounded by collagen fibers and giant cells, at 8 10 weeks it began to be absorbed, and at 12 weeks it was completely absorbed and replaced by collagenous fibers and fibroblast, and the arrangement was similar to that of the real tendon. No rejection action or tention stress reduce were found. The surface was smooth without any adhesion. We used this technique in 118 patients to repair their tendons of figers, shoulders, elbows, knees and achilles. All of the 118 patients obtained satisfactory results. Conclusion: 109HH artificial tendon is considered to be an ideal artificail tendon clinically.