带腱鞘异体肌腱移植的实验研究

EXPERIMENTAL STUDY OF ALLOGENIC TENDON WITH SHEATH GRAFTING IN CHICKEN

目的 探讨深低温冷冻带腱鞘异体肌腱移植的可行性 ,为屈指肌腱 区腱鞘和肌腱缺损重建提供新的修复材料。方法 将 6 0只北京双 A鸡随机分为两组 ,A组为异体移植 ,B组为自体移植。每组再分两个亚组 ,A1全鞘异体肌腱移植 ;A2部分鞘 (滑车 A2～ A4)异体肌腱移植 ;B1全鞘自体肌腱移植 ;B2部分鞘 (滑车 A2～A4)自体肌腱移植。异体材料采用深低温处理 ,移植术后进行组织形态学、移植免疫学及肌腱滑动功能检测。结果 A1组与 B1组移植术后局部组织反应重 ,腱鞘形成生物屏障 ,影响肌腱的营养致使肌腱变性 ,纤维化 ,部分坏死。A 2组与 B2组肌腱愈合良好 ,组织修复能力强 ,腱鞘与肌腱间可分离。带部分腱鞘异体肌腱经深低温处理后 ,其组织抗原性明显降低 ,组织修复能力同自体移植 ,愈合后腱鞘与肌腱间隙存在 ,移植鞘与正常肌腱组织结构相同。

Objective To investigate availability of deep freeze stored allogenic tendon with sheath grafting in repairing the tendon and sheath defect in the Ⅱarea of flexor digitorum tendon. Methods Sixty chickens with tendon and sheath defect were divided into 2 groups randomly, group A was treated with allogenic grafting and group B was treated with autogenic grafting, these two groups were divided into two subgroups respectively, they were, group A1 allogenic tendon with whole sheath grafting, group A2 allogenic tendon with partial sheath grafting, group B1 autogenic tendon with whole sheath grafting and group B2 autogenic tendon with whole sheath grafting. All the allogenic grafts were treated by deep freeze. Histomorphological study, histoimmunological study and slipping function of the grafts were measured after operation. Results In group A1 and B1, the local reaction was sever, the nutrition of tendon graft was barricaded by the whole sheath resulting in adhesion, degeneration and necrosis. In group A2 and B2, the tendon graft healed well and little adhesion existed between tendon and sheath. The results showed that there were significant differences between tendon grafting with whole sheath and tendon grafting with partial sheath. Conclusion Deep freeze store can reduce the immunogenicity of allogenic tendon with sheath. Allogenic tendon with partial sheath grafting can be used as a new biological material for repairing the tendon and sheath defect.