臀肌注射引起髋关节囊挛缩的实验研究  

Experimental research of contracture of hip joint capsule induced by intragluteal injection

作　　者：徐烁 贺西京[2] 党小伍 李浩鹏[2] 于琳华[2] 陈明霞[2] 

机构地区：[1]广东省河源市人民医院骨科,河源517000 [2]西安交通大学第二医院骨科,西安710004

出　　处：《中国矫形外科杂志》2008年第15期1177-1180,共4页Orthopedic Journal of China

摘　　要：[目的]探讨臀肌挛缩中伴随的髋关节囊挛缩的形成机制。[方法]30只幼年中国大耳白兔随机分为苯甲醇青霉素注射组(A组)、苯甲醇注射组(B组)、生理盐水青霉素注射组(C组)、制动加生理盐水注射组(D组)4个组,D组12只,为单髋制动加同侧的臀部注射;余各组每组6只,为双臀注射;各组均采用深肌层注射,每天注射两次,连续注射20 d,并分别于注射后30 d、60 d及90 d手术取材,同时作肢体功能评价,关节囊切片作天狼猩红染色并在普通及偏振光显微镜下观察关节囊形态及胶原的变化。[结果]A、B组幼兔出现臀肌挛缩及髋关节囊增厚、挛缩并反映在后肢功能变化上;天狼猩红染色切片显示A、B组关节囊形态僵硬、成角,胶原增粗,排列紊乱;余组均未出现臀肌挛缩及髋关节囊挛缩。[结论]深层臀肌注射苯甲醇青霉素或苯甲醇能引起幼兔髋关节挛缩,注射后关节囊胶原坏死、崩解,继而增生,排列紊乱,纤维化在关节囊挛缩中起主要的作用,臀肌挛缩所造成的髋关节活动受限因素在关节囊挛缩中不起明显作用。[ Objective] To explore the mechanism of hip joint capsule contracture induced by intragluteal injection. [ Method ] Thirty young Chinese rabbits were divided into four groups of A （ n = 6）, B （ n = 6）, C （ n = 6） and D （ n = 12） at random. Rabbits in groups A, B and C were treated with deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol （group A）, 2% benzyl alcohol （group B） and penicillin dissolved in physiologic saline （group C） . Rabbits in group D were treated with immobilization of unilateral hip joint and deep intramuscular injection of physiologic saline on the homolateral buttock. Each rabbit was injected twice a day for 20 days. Specimens were obtained at 30, 60 and 90 days after first injection and the evaluation of the functions of hind limbs was obtained at the same time. The thickness of hip joint capsules were measured with micrometer and sections of joint capsules were stained by Sirius red and were observed with microscope and polarization microscope. [ Result] Capsules of hip joint in group A and B became thicker and contractural, and the change of joint capsules was reflected in the change of motion of hind limbs. Sections in groups A and B showed shrinked capsules with thick collagens in disordered arrangement ; while there were no gluteus contracture and contraeture of joint capsule in the other groups. [ Conclusion] Deep intragluteal injection of penicillin dissolved in 2% benzyl alcohol or 2% benzyl alcohol into young rabbits can cause contracture of hip joints. The contracture of joint capsule is largely induced by tissue trauma and repair of joint capsules. The limited locomotion of hip joint induced by the contracture of gluteal muscle does not play an important role in the contracture of joint capsule.

关 键 词：苯甲醇 挛缩 髋关节囊 机制 

分 类 号：R684[医药卫生—骨科学]