CO_2激光吻合肌腱的实验研究

Researches on Tendon Repairing with the Carbon Dioxide Laser

本文用37只家兔的148支右后足的第Ⅰ～Ⅳ趾趾深屈肌腱,作二氧化碳激光(CO_2)吻合肌腱实验研究,全部肌腱用手术刀横断。8支肌腱作原始Kessler法重建术,并作生物力学测定。140支肌腱随机分成二组。对照组用Kessler法重建肌腱,用8～0缝线缝合肌腱断端对合处腱外膜。实验组也作Keasler法重建肌腱,用功率3W、光斑直径1.0mm、光脉冲时间0.1s的CO_2激光束对肌腱外膜作环形叠瓦式照射。生物力学测定,二组肌腱的抗断裂强度无显著差异(P>0.05),而二组均优于原始Kessler法的强度(P<0.05)。炎性反应、异物反应和腱周粘连,对照组均比实验组明显。

One hundred and forty-eight tendons of 37 adult rabbits were incised and repaired in digital synovial region by conventional sutures and CO_2 laser The eight tendons of two rabbits were repaired by only a single Kessler suture, and examined by biomechanics The tendons of first to fourth digltorum of right hindfeet of 35 rabbits were divided into a control and an experimental group, randomly. The 70 tendons of the control group were repaired by modified Kessler method with 8-0 suture, whereas the 70 tendons of the experimental group were repaired by simple Kessler suture with a ring welding of epitenon of anastomosis between the cut ends of tendon using CO_2 laser beam irradiation. The results examined by biomechanics demonstrated that tendon strength was no significant. difference (P>0.05) between the control group and the experimental group, while the two groups were stronger than that of the tendon repaired by the single Kessler suture with statistical significance (P<0.05). Histological examination showed that more severe foreign body reaction and aseptic inflammation as well as tissue adherence around the tendons could be seen in the control group. The results of this investigation demonstrated that. 1. CO_2 laser could be used for tendon welding and the tendons have the same level of strength. 2. Tendon welding by CO_2 laser have some advantages than that tendon repairing by sulure. 3. Tendon welding by CO_2 laser may reduce tendon adhesion,