小腿截肢残端假体的实验研究  

An experimental study on the stump prosthesis for the amputated lower extremities in goats

作　　者：赵文汝[1] Gregory A.Zych D.O. 王秀汝[1] 周庆芬[3] 索广文 

机构地区：[1]首都医科大学宣武医院功能治疗科,北京长椿街45号100053 [2]Department of Orthopedics & Rehabilitation,University of Miami School of Medicine [3]北京矿务局创伤研究中心

出　　处：《中国康复医学杂志》2003年第9期548-551,共4页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:利用残端假体增加下肢截肢后骨残端的横截面积,降低负重时截肢残端皮肤单位面积上的压强,减少由于穿戴假肢所引起的并发症。重建离断肌肉的下位附着点,使之保持肌肉的合适初长和原有肌力,并维持肌力平衡,防止关节挛缩畸形,以保持截肢平面上位关节的正常活动,提高截肢肢体穿戴假肢后的功能。方法:山羊10只,随机分为2组,左小腿膝下截肢后,分为对照组和假体放置组。假体采用超高分子聚乙烯材料制成,呈蘑菇状外观。术后穿戴假肢开始负重。观察站立和行走的时间,残端皮肤情况,并进行骨残端组织学检查。结果:假体放置组羊能在截肢术后较早穿戴假肢,负重站立和行走,无残端皮肤溃疡。假体与残端骨接合紧密,肌腱与假体连接良好,坚固。未发现任何假体放置后的不良反应和并发症。结论:截肢后骨残端安放假体能明显增加骨残端横截面积,很好保持残肢末端的圆锥形,加之假体材料的缓冲作用,明显减少截肢骨残端与假肢接受腔间软组织单位面积上的压强,使之能较早安装假肢,减少穿戴假肢所引起的并发症,增加假肢穿戴后的肢体功能。Objective:To promote the function of lower extremity prosthesis and prevent jo int contracture deformity by means of increasing stump cross section,lowering th e local pressure,reestablishing the musle initial length and muscle balance.Meth od:10goats were divided into two groups randomly after amputation,the control gr oup and stump prosthesis placed group.The stump prosthesis was made of UHMWRE(ul tra-macromolecular polyethylene)and its shape looked like a mushroom.The time be gin to bare weight,stand and walk with wearing artificial limb after amputation, the situation of the stump skin and the pathological evidence of the stump bone were observed.Result:The time of wearing prosthesis begin to stand and walk was significantly earlier in the prosthesis group than that in the control group.The skin of the stump looked normal.The conjugation of the prosthesis with stump en d was tight.Conclusion:The prosthesis can significantly increase the cross secti on of contract and decreases the intensity of pressure on each unit area of the soft tissue between the stump and the prosthesis.This makes the goats can wear t he artificial limb earlier without complication and the function of the leg can be improved.

关 键 词：小腿 截肢 残端 实验 人工假体 并发症 

分 类 号：R318.17[医药卫生—生物医学工程]