生物与非生物性腱鞘代用品预防屈肌腱粘连作用效果比较的实验研究

A Comparative Study of Biological and Nonbiological Sheath Substitute in Prevention of Flexor Tendon Adhesions

目的:以生物膜与金箔为代表,观察生物与非生物性腱鞘代用品预防屈肌腱粘连的作用机制及效果,并加以比较,为临床应用提供可靠的理论及实验依据。方法:应用鸡趾屈肌腱横断修复模型,不同时间取材,通过生物力学、大体观察、组织学及电镜检查,观察肌腱愈合情况、粘连形成情况及假鞘结构。结果:生物膜与金箔组肌腱均为内源性愈合,并形成具有正常滑膜A、B型细胞的假鞘结构,与肌腱间有间隙。结论:(1)生物膜与金箔防粘连作用机制相似,都是通过形成假鞘来发挥作用,作用效果无明显差异。(2) 用具有良好组织相容性的物质将肌腱与周围组织分隔,将有效地防止肌腱粘连。

Objective:A biological membrane and gold foil as presents of sheath substitute were used in experiments to observe the effects in prevention of flexor tendon adhesion and the mechanism through which the effects come and they were compared with each other,in order to supply a reliable experimental evidence for clinical application. Methods:The specimens from chicken lacerated tendons model were taken postoperatively at different time for biomechanical,gross,histological and ultrastructual examinations.Results:Tendon healing both in biological membrane and gold foil groups were intrinsic and pesudosheath,which has synovial A、B cells, was formed around the injured tendon.There was a gap between pesudosheath and tendon.Conclusion:1)The mechanism and effect were similar for biological membrane and gold foil to prevent adhesions in the flexor tendon repair. 2)The tendon adhesion may be prevented effectively with materials which have a good histocompatibility seperating tendon from around tissues and thus the tendon's gliding function,will be improved.