肌腱损伤修复过程及粘连的预防  

Repair of tendon injury and prevention of adhesion

作　　者：刘汉辉[1,2] 章莹[1] 吴文[1] 谭新宇[1,2] 

机构地区：[1]解放军广州军区广州总医院骨科医院创伤骨科,广东省广州市510010 [2]广州医学院研究生处2007级研究生班,广东省广州市510182

出　　处：《中国组织工程研究与临床康复》2009年第50期9946-9949,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：肌腱损伤后愈合包括内源性愈合、外源性愈合两种形式。防止肌腱粘连的理想途径,是通过改善肌腱的营养状况和周围环境,来促进内源性愈合,抑制或减轻外源性愈合。常用的预防肌腱粘连方法有:全身或局部应用药物、保护和修复腱鞘、采用自体组织或合成材料代腱鞘、肌腱移植与腱鞘再造等,均取得了一定效果。采用可降解吸收的高分子生物材料屏障预防肌腱粘连,是近年来临床应用的热点。采用中医中药疗法、康复理疗及早期保护性活动,均可一定程度预防粘连发生。组织工程化肌腱移植,可能是今后研究的一个方向。在肌腱损伤早期,采用无创技术、非绞窄性缝合,手术中尽量保留或修复腱鞘,外周应用高分子生物材料包裹,术后结合康复理疗及早期保护下功能锻炼的综合治疗方法,可明显预防粘连发生,最大限度地恢复肌腱的滑动功能。Tendon healing following injury includes two forms, endogenous healing and exogenous healing. The ideal way of preventing adhesion of tendon is to improve the nutritional state and the surrounding environment of tendon so as to promote endogenous healing and restrain/ease exogenous healing. The normally-used method for preventing the adhesion includes： systemic or partial administration, protection and repair of tendinous sheath, substitution of tendinous sheath with autologous tissue or synthetic material, tendon transplantation, tendinous sheath reconstruction and so on, all of which do have some curative effects However, recent research focus has come down to the degradable and absorbable polymeric biomatedals that can be used as barriers for preventing the adhesion. Besides, traditional Chinese medicine, rehabilitation therapy and early protected motion all can prevent the adhesion to some degree. In future, the tissue engineering tendon transplantation may become an investigative aspect. By using atraumatic technique and non-strangulated suture in the earlier period after tendon injury, warding and repairing tendinous sheath as much as possible as well as packaging the tendon with polymeric biomatedals during operation, and adopting combined therapy of rehabilitation therapy together with early protected motion after operation, we can prevent tendon adhesion obviously and have the gliding function of tendon recovered to the greatest extent.

关 键 词：肌腱损伤 修复 粘连 

分 类 号：R318[医药卫生—生物医学工程]