脱细胞羊膜预防生物衍生肌腱修复鸡屈趾肌腱Ⅱ区缺损修复后的粘连

Effects of humnan acellular amniotic membrane on preventing tendon adhesion after repairing digital flexor tendons by derived tendon in chickens

背景:羊膜有预防肌腱修复后粘连的作用,但存在一定的免疫排斥反应。目的:探讨脱细胞羊膜对生物衍生肌腱修复鸡屈趾深肌腱Ⅱ区缺损修复后肌腱粘连的预防作用。方法:分别以罗曼鸡右爪的第2,3,4趾将实验分成生物衍生肌腱组,生物衍生肌腱+脱细胞羊膜组以及自体肌腱组,建立屈趾深肌腱Ⅱ区1cm缺损模型。以生物衍生肌腱桥接第2,3趾缺损,以自体肌腱桥接第4趾的肌腱缺损,在第3趾的生物衍生肌腱和上下吻合口周围包裹完整的脱细胞羊膜。结果与结论:生物衍生肌腱组与自体肌腱组移植物为外源性愈合,生物衍生肌腱+脱细胞羊膜组羊膜有效地防止了成纤维细胞向修复区域内浸润,形成内源性愈合。肌腱粘连程度生物衍生肌腱+脱细胞羊膜组优于生物衍生肌腱组和自体肌腱组,生物衍生肌腱组和自体肌腱组相似,移植物周围的炎症反应生物衍生肌腱+脱细胞羊膜组>生物衍生肌腱组>自体肌腱组。证实脱细胞羊膜能通过机械性阻挡周围肉芽组织向修复区域内生长而防止外源性愈合造成的肌腱粘连。

BACKGROUND：Amnion can depress the degree of tendon adhesion,but also can induce the immune reaction. OBJECTIVE：To evaluate the effects of human acellular amniotic membrane（HAAM） on Roman chickens tendon adhesion when the derived tendon materials were used to repair the flexor digitorum profundus tendon defects. METHODS：The flexor digitorum profundus tendons of three fingers of each claw in 40 Roman chickens were resected and 1 cm defect was made as experimental model. The defects were repaired by three methods respectively（group A：derived tendon materials;group B：derived tendon materials encapsulated by HAAM;group C：autograft） . RESULTS AND CONCLUSION：In group A and C,the tendon grafts were healed exogenously. In group B,the fibroblast infiltration was stopped by HAAM efficiently and the tendon grafts healed endogenously. The degree of adhesion：group B was better than group A and group C,group A was similar with group C. The inflammatory reactions around grafts were group Bgroup Agroup C. HAAM lessened the tendon adhesion by mechanically preventing the exogenous healing caused by granulation tissue infiltrating the anastomotic stoma and would be a good biological material in preventing postoperative adhesions of flexor tendon.