生物羊膜联合玻璃酸钠在手部屈肌腱Ⅱ区损伤治疗中的应用分析  

Analysis of the Use of Bioamniotic Membrane Combined with Sodium Vitrate in Patients with Flexor Tendon Ⅱ Injuries of the Hand

作　　者：马韬 杨晓光 林燕鹏 时艳程 田德虎 MA Tao;YANG Xiaoguang;LIN Yanpeng;SHI Yancheng;TIAN Dehu(Zhangjiakou Second Hospital,Zhangjiakou 075000,Hebei China;The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]张家口市第二医院,河北张家口075000 [2]河北医科大学第三医院

出　　处：《中国中医骨伤科杂志》2023年第5期70-75,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：张家口市科技局自筹经费项目(2021121D)。

摘　　要：目的:探讨生物羊膜联合玻璃酸钠预防肌键粘连作用及其临床效果。方法:选取2020年1月至2021年1月收治的102例手部屈肌腱Ⅱ区损伤患者进行前瞻性研究,均行肌腱吻合术,随机数字表法分为观察组和对照组,各51例。对照组给予玻璃酸钠治疗,观察组在对照组基础上联合生物羊膜治疗。比较两组手部活动功能的优良率、术后不同时间点患指总的主动活动度(TAM)、手指对应的指尖与手掌的垂直距离、手术前后实验室指标(表皮生长因子(EGF)、血管内皮生长因子(VEGF)、成纤维细胞生长因子(bFGF))水平变化、手精细度和灵活度及肌腱粘连率、不良事件情况。结果:术后1个月、3个月、6个月观察组手功能主动活动度值均高于对照组,且术后6个月手功能分级优于对照组,优良率(96.08%)高于对照组(80.39%),差异有统计学意义(P<0.05);术后1个月、3个月、6个月观察组手指尖与手掌的垂直距离均小于对照组,且术后6个月手指尖与手掌的垂直距离分级优于对照组,优良率(86.27%)高于对照组(70.59%),差异有统计学意义(P<0.05);术后第7天和第14天观察组表皮生长因子、成纤维细胞生长因子水平高于对照组,血管内皮生长因子水平低于对照组,差异有统计学意义(P<0.05);术后6个月观察组手精细度和灵活度均优于对照组,差异有统计学意义(P<0.05);观察组肌腱粘连发生率(3.92%)低于对照组(21.57%),差异有统计学意义(P<0.05);两组术后局部伤口无渗出、红肿等炎性反应,均一期愈合;全身未出现过敏、发热等不良事件。结论:在手部屈肌腱Ⅱ区损伤中,生物羊膜联合玻璃酸钠能促进肌腱愈合,降低肌腱粘连风险,恢复手功能,提高关节活动度,可能与生物羊膜富含表皮生长因子及成纤维细胞生长因子等多种生长因子有关。Objective:To compare the clinical efficacy of bioamniotic membrane combined with sodium hyaluronate and sodium hyaluronate in patients with flexor tendon zone Ⅱ injury, and to explore the effect of bioamniotic membrane combined with sodium hyaluronate in preventing muscle adhesion and its clinical efficacy.Methods:102 patients admitted to our hospital with injuries to the flexor tendon zone Ⅱ of the hand were retrospectively selected from January 2020 to January 2021,all cases underwent tendon anastomosis and were divided into an observation group and a control group of 51 cases each according to the treatment protocol.The control group was treated with sodium hyaluronate, and the observation group was combined with biological amniotic membrane treatment on the basis of the control group.Comparison of the excellent and good rate of hand movement function between the two groups, including the total active range of motion(TAM) of the affected finger at different time points after the operation, the vertical distance between the fingertip and the palm of the finger, and the laboratory indicators before and after the operation(EGF),vascular endothelial growth factor(VEGF),fibroblast growth factor(bFGF) level changes, hand fineness and flexibility, tendon adhesion rate, adverse events.Results:The TAM values of hand function in the observation group were higher than those in the control group at 1 month, 3 months, and 6 months after operation, and the excellent and good rate of hand function TAM value at 6 months after operation was 96.08% higher than that of the control group 80.39%.The difference was statistically significant(P<0.05), the vertical distance between the fingertip and the palm of the observation group was smaller than that of the control group at 1 month, 3 months, and 6 months after the operation, and the excellent and good rate of the vertical distance between the fingertip and the palm at 6 months after the operation 86.27% was higher than 70.59% in the control group, and the difference was stati

关 键 词：生物羊膜 玻璃酸钠 屈肌腱Ⅱ区损伤 肌腱粘连程度 手部活动功能 

分 类 号：R686.1[医药卫生—骨科学]