被动功能锻炼预防屈肌腱粘连的实验研究  

Experimental study of passive functional exercise to prevent flexor tendon adhesion

作　　者：程杰 王继宏[1] 樊东升[1] 郝增涛[1] 景尚裴 韩超前[1] 王永飞[1] 殷超[1] 许鹏成 温树正[1] Cheng Jie;Wang Jihong;Fan Dongsheng;Hao Zengtao;Jing Shangfei;Han Chaoqian;Wang Yongfei;Yin Chao;Xu Pengcheng;Wen Shuzheng(Department of Hand and Foot Microsurgery,the Second Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia 010030,China)

机构地区：[1]内蒙古医科大学第二附属医院手足显微Ⅱ科,内蒙古010030 [2]河北省沧州中西医结合医院

出　　处：《中华手外科杂志》2018年第5期371-374,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨减轻鸡肌腱粘连被动功能锻炼的合适次数和强度。方法取10月龄三黄鸡100只，随机分成5组，每组20只。制作右足第三趾Ⅱ区趾深屈肌腱横断模型，用津下（Tsuge）缝合法缝合。A组右足不用石膏固定和被动功能锻炼；B、C、D、E组右足用石膏固定，且被动功能锻炼的次数分别为每天1、2、3次和不功能锻炼。术后4周观察鸡爪的抓握形态、记录肌腱滑移距离及跖趾关节和趾间关节屈曲总角度、肌腱缝合端的形态及腱周粘连度分级评定、HE染色中每高倍视野下腱细胞的形态和数目之和、羟脯氨酸含量的测定。对数据进行统计学分析。结果A组所有标本在术后5d左右肌腱完全断裂，不再进行其余指标的检测。鸡爪的抓握形态：B组标本显示略有抓握形态C、D组标本显示有较好的抓握形态E组所有标本几乎无抓握形态。肌腱缝合端形态C、D、B、E组可见标本缝合端膨大逐渐增大，质地逐渐变硬，腱周组织瘢痕逐渐增多，粘连程度逐渐加重。其余指标C组明显好于其他组，差异有统计学意义（P〈0．05）。结论每天2次充分的被动功能锻炼能有效减轻鸡趾深屈肌腱粘连的发生。Objective To evaluate the exercise to reduce tendon adhesion in chickens. appropriate frequency and intensity of passive functional Methods One hundred sanhuang chickens at the age of 10 months were randomly divided into five groups with 20 in each group. The chicken model of transection of flexor digitorum profundus tendon of the third toe at Ⅱ zone of the right foot was made and the transected tendon was sutured using Tsuge method. The right foot of group A did not use plaster fixation and conduct passive functional exercise, while it of group B, C, D and E was fixed with plaster and the times of passive functional exercises were once, twice, third times and zero respectively. Four weeks after the operation, the grip shape of the claws was observed; the distance of the tendon slip, the total angle of the flexion of the metatarsophalangeal and interphalangeal joint were documented; the shape of the suture end of the tendon and the grading of peritendinous adhesion degree were evaluated; the morphology and number of tendon cells and the content of hydroxyproline under each high magnification field by HE staining were measured. Statistical analysis of data was performed. Results All the flexor tendons in group A were completely ruptured at 5 days after the operation, and the other indicators were no more collected. The grip shape of the claws： group B showed slightly grasping shape; group C and D showed good grasping shape; group E had almost no grasping shape. The shape of suture end of tendon： for group C, D, B and E, the enlargement at the suture end of the specimen gradually increased, the texture gradually hardened, the scar around the tendinous tissue gradually increased, and the degree of adhesion gradually increased. The remaining results in group C were significantly better than those in other groups （P〈0.05）. Conclusion The passive functional exercise twice a day can effectively reduce the incidence of flexor digitorum profundus tendon adhesion.

关 键 词：腱损伤 动物实验 肌腱粘连 被动功能锻炼 

分 类 号：R686[医药卫生—骨科学]