自体骨膜促进兔肩袖腱骨愈合的疗效  

Therapeutic effect of autologous periosteum on the healing of tendon-bone interface in rabbit rotator cuff tear

作　　者：赵杨[1] 戴海峰[1] 刘莎莎[1] 王智慧[1] 李嘉[1] 

机构地区：[1]承德医学院附属医院,河北承德067000

出　　处：《中国比较医学杂志》2018年第2期74-79,共6页Chinese Journal of Comparative Medicine

基　　金：2015承德市科技局发展计划项目(20157047)

摘　　要：目的研究自体骨膜促进肩袖腱骨愈合的疗效研究。方法选用60只新西兰兔建立急性肩袖损伤模型,按照手术方式分为实验组(自体骨膜补片+缝合固定)、对照组(单纯缝合固定)。分别于术后4、8、12周取标本进行光镜观察,并进行生物力学测试。结果实验组术后4周间充质细胞增生明显,骨膜内可见少量新生软骨细胞和基质;术后8周可见大量未成熟软骨细胞,排列略规整,部分向肌腱内长入;术后12周软骨细胞排列规整,类似正常的腱骨界面结构。实验组腱骨连接紧密程度及止点软骨细胞排列明显优于对照组。生物力学测试,实验组抗牵拉强度也明显高于对照组,差异有显著性(P<0.05)。结论使用自体骨膜作为补片加强修复肩袖能有效促进腱骨愈合,缩短肩袖愈合时间,具有良好的生物学特性,为临床肩袖修复手术提供了实验基础。Objective To study the effect of autologous periosteum on the healing of tendon-bone interface in rabbit rotator cuff tear. Methods Supraspinatus tenotomy was performed on one side shoulder in 60 New Zealand white rabbits to establish the model of rotator cuff tear. The rabbits were randomly divided into two groups： the study group（ used autologous periosteum to promote the suture fixation） and control group（ simple suture fixation）. The rabbits were sacrificed at 4,8 and 12 weeks postoperatively with twenty rabbits sacrificed each time. Tissue samples of the tendon-bone interface was taken for histological examination and biomechanical test was performed to assess the strength of tendon-bone junction. Results At 4 weeks the study group showed extensive inflammatory cell infiltration,and a small amount of chondrocytes and extracellular matrix. At 8 weeks,the study group showed a large amount of immature chondrocytes arranged rather regularly. At 12 weeks,the tendon bone junction appeared similar to normal. In the study group,both the tendon-bone connection and the arrangement of chondrocytes were significantly better than the control group. The result of biomechanical testing showed that the highest tendon load in the study group was significantly higher than the control group（ P〈0. 05）. Conclusions The use of autologous periosteum as a patch to strengthen the repair of the rotator cuff tear can effectively promote the healing of tendon bone interface,shorten the rotator cuff healing time and has good biological properties. This method provides an experimental basis for clinical rotator cuff repair surgery.

关 键 词：自体骨膜 肩袖损伤 腱骨愈合 

分 类 号：R-33[医药卫生]