构建趾深屈肌腱横断模型:移植腱周膜预防肌腱粘连

Construction of deep flexor tendon transection models: peritenon transplantation prevents tendon adhesions

背景:肌腱修复术后肌腱与周围组织的粘连问题一直是临床工作中难以解决的问题之一。目的:构建雌性来亨鸡制备双爪第3趾趾深屈肌腱横断模型,研究腱周膜移植对预防肌腱术后粘连的作用。方法:造模成功后,左爪第3趾为实验组1,肌腱切断后缝合,取鸡同侧第4趾趾深屈肌腱腱周膜包绕实验组1肌腱吻合端,左爪第4趾为实验组2直接缝合皮肤。右爪第3趾为对照组1,肌腱切断后缝合,不修复腱周膜;右爪第4趾手术不损伤腱周膜为对照组2,肌腱进行大体观察和组织学观察。结果与结论:术后28 d,来亨鸡肌腱大体观察及组织学观察采用Kruskal-WallisH和Nemenyi检验两两比较,实验组1术后效果优于对照组1(P<0.05),但较对照组2及实验组2略差(P<0.05);实验组2术后效果优于对照组1组(P<0.05),与对照组2比较,差异不显著(P>0.05)。屈趾功能采用LSD-t检验两两比较,实验组1术后效果优于对照组1(P<0.05),但较对照组2及实验组2略差(P<0.05),实验组2术后效果优于对照组1(P<0.05),与对照组2比较,差异不显著(P>0.05)。结果提示,腱周膜移植可以有效预防术后肌腱粘连,切取腱周膜对正常肌腱滑动影响不大。

BACKGROUND：The adhesion between muscle tendon and surrounding tissue after tendon restoration is one hot topic in clinic. OBJECTIVE：To construct a deep flexor tendon transection model in the third toe of female Leghorn chicken and to explore the effect of peritenon transplantation on the prevention of tendon adhesions. METHODS：After the transection models were successful y established, the third toe of left claw was taken as experimental group A. The transected tendon was sutured, the tendon anastomosis end was wrapped with the peritenon of the deep flexor tendon from the ipsilateral fourth toe （experimental group B）. The third toe of right claw served as control group A, the transfected tendon was sutured and restored with the peritenon. The fourth toe of right claw was taken as control group B. Gross observation and histological observation of the tendon were performed. RESULTS AND CONCLUSION：At 28 days postoperatively, gross observation and histological observation of Leghorn chicken were performed and compared using the Kruskal-Wal isH and Nemenyi test, respectively. The results showed that, the therapeutic effect was better in experimental group A than in control group A （P0.05）. The flexor function was evaluated and compared with the least significant difference t-test. The results showed that the postoperative effect was better in experimental group A than in control group A （P0.05）. Peritenon transplantation can effectively prevent tendon adhesions and has little impact on normal tendon sliding.