5-氟尿嘧啶联合大清止血膜预防肌腱粘连的临床研究  

Clinical research of joint 5-fluorouracil and Daqing hemostatic membrane in prevention of tendon adhesion

作　　者：周智[1] 左文山[1] 谢跃[1] 王黎明[2] 

机构地区：[1]南京医科大学附属淮安第一医院骨科,223300 [2]南京医科大学附属南京医院骨科,210000

出　　处：《疑难病杂志》2014年第3期291-293,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的评价5-氟尿嘧啶联合大清止血膜预防肌腱粘连的临床疗效。方法屈指肌腱损伤患者80例随机分成观察组(40例)和对照组(40例),观察组在肌腱吻合术后局部应用5-氟尿嘧啶25 mg/ml浸泡的脑棉片贴合于肌腱修复部位的腱鞘滑膜面,然后用大清止血膜覆盖预防肌腱粘连;对照组常规肌腱吻合后用生理盐水冲洗。观察2组术后4周和8周肌腱总主动活动度的变化,以及3个月行肌腱松解患者增生肌腱瘢痕组织TGF-β_1、MMP-9的比较。结果 80例患者创口均Ⅰ期愈合,术后4周和8周观察组肌腱总主动活动度优于对照组(分别为205.05°±7.33°vs.185.10°±4.36°和257.20°±6.46°vs.201.30°±5.34°,P<0.05);3个月后观察组TGF-β_1和MMP-9低于对照组[(220±46)个/cm^2 vs.(372±81)个/cm^2和(11.96±1.45)mg/g vs.(11.91±1.60)mg/g,P<0.05]。结论5-氟尿嘧啶联合大清止血膜可应用于预防屈指肌腱损伤术后肌腱粘连且效果良好,值得推广。Objective To evaluate the joint 5-fluorouracil and Daqing hemostatic membrane＆#39;s clinical efficacy of pre-vent tendon adhesion.Methods 80 patients with flexor tendon injury were randomly divided into observation group （40 ca-ses） and control group （40 cases）, in the observation group, after topical application of 5-fluorouracil 25 mg/ml cotton soaked in the tendon piece fit in the synovial tendon sheath repair site surface , then covered with a Daqing hemostatic mem-brane to prevent tendon adhesion ; control group with conventional saline water tendon anastomosis .Observe the 2 groups post-operative four weeks＆#39;and 8 weeks＆#39;tendon changes in the total active motion , and comparing 3 months hypertrophic tendon scar tissue TGF-β1 and MMP-9 in patients with release treatment .Results 80 patients were stage I wound healed , after 4 and 8 weeks, total active tendon in observation group better than the control group （205.05＆#176;＆#177;7.33＆#176;vs.185.10＆#176;＆#177;4.36＆#176;and 257.20＆#176;＆#177;6.46＆#176;vs.21.30＆#176;＆#177;5.34＆#176;, P ＆lt;0.05）; after 3 months, the observation group＆#39;s TGF-β1 and MMP-9 lower than the control group [ （220 ＆#177;46） cells /cm 2 vs.（372 ＆#177;81） cells /cm 2 and （11.96 ＆#177;1.45） mg/g vs.（11.91 ＆#177;1.60） mg/g, （P ＆lt;0.05）].Conclusion 5-fluorouracil and Daqing hemostatic membrane can be applied to prevent tendon adhesions after flexor tendon injury and the result is good , worthy of promotion.

关 键 词：5-氟尿嘧啶 大清止血膜 粘连 肌腱 TGF-Β1 MMP-9 TGF-Β1 MMP-9 

分 类 号：R687.2[医药卫生—骨科学]