链霉素缓释复合降解膜植入损伤肌腱局部腱周结缔组织的变化  

Connective tissue changes at the position of tendon injury following implantation of streptomycin combined with slow-releasing biodegradable membrane

作　　者：富玲[1] 宋宁[1] 苏学忠[2] 李娜然[3] 孙佩杰[3] 苏秋香[3] 杨晓霞[4] 

机构地区：[1]沈阳医学院奉天医院手外科,辽宁省沈阳市110024 [2]沈阳医学院,辽宁省沈阳市110034 [3]沈阳医学院形态中心,辽宁省沈阳市110034 [4]沈阳医学院病理教研室,辽宁省沈阳市110034

出　　处：《中国组织工程研究与临床康复》2011年第21期3895-3899,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:国内外学者曾用生物、非生物及药物等方法,诸如生物膜、透明质酸钠、纤维素密封胶等材料进行大量肌腱修复防粘连研究,但到目前为止尚未取得突破性进展。目的:观察肌腱损伤局部植入链霉素复合降解膜后腱周结缔组织的增生。方法:切断SD大鼠跟腱后,随机数字表法分为3组,分别在肌腱断端缝合处植入链霉素复合缓释降解膜、维生素C复合缓释降解膜、空白缓释降解膜。术后90d行肌腱损伤局部组织学观察、羟脯氨酸含量和生物力学指标检测。结果与结论:链霉素复合缓释降解膜组肌腱缝合处内部的成纤维细胞、胶原纤维均较其腱周围、维生素C复合缓释降解膜组、空白缓释降解膜组多;腱缝合处肌腱周围多为正常结构的疏松结缔组织,很少有增生的结缔组织长入肌腱内部;肌腱与周围组织分界清晰,最大抗拉强度、羟脯氨酸含量明显优于其他两组。表明链霉素复合缓释降解膜通过抑制腱周结缔组织增生,防止腱周结缔组织增生长入腱内,从而减轻或防止粘连形成。BACKGROUND：Domestic and foreign scholars have used biological,non-biological,drug and other methods,such as biofilm,sodium hyaluronate,cellulose sealant,to perform a large number of studies on anti-adhesion tendon repair.However,there is no breakthrough up to now.OBJECTIVE：To observe the proliferation of connective tissues after implantation of streptomycin combined with slow-releasing biodegradable membrane.METHODS：After tendon cutting,SD rats were randomly divided into three groups：In group A,streptomycin combined with slow-releasing biodegradable membrane was implanted into the sutured site of Achilles tendon;in group B,vitamin C combined with slow-releasing degradable membrane were implanted;in group C,single slow-releasing degradable membrane was used.After 90 days,histological observation was performed for tendon injury as well as tractus hydroxyproline content and biomechanics indexes were measured.RESULTS AND CONCLUSION：In the group A,there were more fibroblasts and collagen fibers in the sutured site of Achilles tendon than its surrounding tissues,group B and group C.Surrounding the sutured site,many loose connective tissue with normal structure could be seen,but few hyperplastic connective tissues grew into the tendon.A clear demarcation existed between the tendon and its peripheral tissues.The content of hydroxyproline and the ultimate tensile strength in group A were higher than those of groups B and C.The findings show that streptomycin combined with slow-releasing biodegradable membrane can alleviate or prevent tendon adhesion through inhibiting peripheral connective tissue proliferation and preventing connective tissue to grow into the tendon.

关 键 词：肌腱损伤 链霉素 缓释降解膜 维生素C 粘连 

分 类 号：R318[医药卫生—生物医学工程]