聚乳酸凝胶预防肌腱吻合术后粘连的实验研究(英文)  

Polylactic acid gel for preventing tendon adhesion after tendon anastomosis

作　　者：刘立岷[1] 宋跃明[1] 段宏[1] 丁永利[1] 卢冰[1] 

机构地区：[1]四川大学华西医院骨科,四川省成都市610041

出　　处：《中国临床康复》2004年第26期5710-5711,F003,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:肌腱吻合术后易粘连而影响功能恢复,近年来多采用固态物质为隔膜以利于肌腱滑动,但效果不理想。目的:观察聚乳酸凝胶(PLA-G)预防肌腱吻合部粘连作用。设计:随机自身对照实验研究。地点和对象:实验在四川大学华西医院动物实验外科完成,对象为16只日本大耳白兔,雌雄不限(由该科室提供)。干预:将16只兔左后肢比目鱼肌腱切断一半后吻合,鞘内涂PLA-G为实验组;兔的右后肢同样操作,不涂PLA-G为对照组。术后2,4,6,10周观察结果。主要观察指标:手术段肌腱和鞘管作大体、组织学及超微结构观察。结果:①大体观察:实验组2周时PLA-G隔离好无粘连;4周开始降解,肌腱滑动良好;6,10周瘢痕小,吻合口生长及滑动良好。对照组瘢痕大、广泛粘连。②组织学观察:实验组纤维排列由不规则向规则变化,成纤维细胞少。对照组腱与鞘无分界,成纤维细胞增生、胶原分泌活跃。③超微结构:实验组成纤维细胞粗面内质网较对照组明显稀疏、胶原纤维少。结论:PLA-G具有防粘连作用,不影响肌腱愈合。BACKGROUND:Tendon adhesion after tendon anastomosis happens easily,which affects functional recovery.A few materials have been used to prevent adhesion,but there is not yet an ideal material.Recent investigations mostly used solid materials as diaphragm to make tendons move easily. OBJECTIVE:To determine the ability of the polylactic acid gel (PLA G)in preventing tendon adhesion. DESIGN:A randomized controlled trial was conducted. SETTING and PARTICIPANTS:The experiment was completed in the Department of Laboratory Animal Surgery,West China Hospital,Sichuan University.Sixteen Japanese white rabbits were used in this experiment in either gender(provided by this Department). INTERVENTIONS:The tendons of the soleus muscle of the left hind legs of 16 rabbits were partially separated and the transverse incisions were made over half of their cross section.The incision sites were then anastomosed and covered up with the PLA G.In the control group(the tendons of the soleus muscle of the right hind legs of the rabbits),the tendons were done according to the left and no PLA G was used at the anastomosis site. MAIN OUTCOME MEASURES:Gross,histological and ultrastructural observations were performed on the tendons and sheaths in the operated parts. RESULTS:①Gross observation:In the experimental groups,on the 2nd week,the PLA G had good separating function;the tendons and sheaths did not adhere to each other.In the 4th week,the PLA G began to degrade,but the moving function of the tendons was good.In the 6th and 10th week,there was a little scar in local space,and the tendons grew well in anastomosis and could slide smoothly.While in control groups there was a large proliferative scar in the sheaths,the tendons and sheaths adhered commonly.②Histological observation:in trail groups the arrangement of the tendon fibers at the anastomosis site progressed from irregularly to regularly as time went by;the surface of the tendons was smooth;the fibroblast proliferated inactively.In control groups,the tendon fibers and

关 键 词：腱 吻合术 外科 粘连 聚合物 乳酸盐类 

分 类 号：R318[医药卫生—生物医学工程]