保留残迹前交叉韧带重建对移植物血供恢复的影响  

Effect of remnant preservation on vascularization of grafts in anterior cruciate ligament reconstruction

作　　者：吴波[1] 李士光[1] 赵宗峤[1] 孙磊[1] 

机构地区：[1]解放军第八十八医院全军骨科中心,泰安271000

出　　处：《中华创伤杂志》2013年第5期470-473,共4页Chinese Journal of Trauma

摘　　要：目的探讨保留韧带残迹对前交叉韧带（anterior cruciate ligament, ACL）重建术移植物血供恢复的影响。方法选择78只新西兰兔I期行双侧膝关节ACL重建术，一侧保留止点残迹纤维（保留残迹组），对侧清除残迹纤维（切除残迹组）。重建术后6，12，18及24周采用激光多普勒血流计、免疫荧光染色及墨汁灌注染色，检测移植物血流量恢复、血管形成等情况。结果重建术后6，12，18，24周时，激光多普勒血流计检测结果显示保留残迹组移植物血流量明显高于切除残迹组（P〈0．01），且免疫荧光检测结果显示保留残迹组移植物CD34阳性表达量显著高于切除残迹组（P〈0．05）。墨汁灌注计数结果显示，重建术后保留残迹组移植物血管形成数量亦较切除残迹组明显增加（P〈0．05）。结论保留残迹有利于ACL重建术后移植物血运的早期恢复。Objective To investigate influence of preservation of remnant ligament on vascularization of grafts in anterior eruciate ligament （ACL） reconstruction. Methods Seventy-eight New Zealand rabbits were involved and both knees of the rabbits received one-stage ACL reconstruction simultaneously. One knee was reconstructed with preservation of residual fibers （remnant preservation group） , and the eontralateral one was treated with conventional debridement of residual fibers （remnant removal group）. Blood flow of grafts was evaluated in vivo by laser doppler flow meter, expression of CD34 in vessels of grafts was measured by immunofluorescence method, growth of vessels surrounding grafts was observed with ink perfusion under stereomicroscope at 6, 12, 18, and 24 weeks after reconstruction. Results Laser doppler flow meter showed blood flow of grafts was significantly larger in remnant preservation group than in remnant removal group （P 〈 0.01 ）. Immunofluorescence testing revealed positive expression of CD34 of grafts was notably higher in remnant preservation group than in remnant removal group （P 〈 0.05 ）. Ink perfusion showed that the number of vessels surrounding grafts was much more in remnant preservation group than that in remnant removal group （ P 〈 0.05 ）. Conclusion Remnant preservation benefits the vascularization of grafts in early stage after ACL reconstruction.

关 键 词：前交叉韧带 修复外科手术 移植物 兔 血管化 

分 类 号：R687.4[医药卫生—骨科学]