CAJ | 학술논문

目的探讨射频紧缩对腕关节骨间韧带组织学结构的影响.方法选取6具新鲜成年男性尸体的双侧前臂标本,右侧标本进行射频紧缩治疗,而左侧标本作为正常对照.将主要的腕骨间韧带制备成骨-韧带-骨结构,然后进行包埋、切片,分别进行HE、甲苯胺蓝、苦味酸天狼星红染色,以及Ⅲ型胶原的免疫组织化学染色,并通过图像分析软件比较染色结果.结果HE和甲苯胺蓝染色显示舟月骨间背侧韧带(SL-d)的组织结构与月三角掌侧韧带(LT-v)类似,而舟月掌侧韧带(SL-v)与月三角背侧韧带(LT-d)类似,舟月近侧韧带(SL-m)和月三角近侧韧带(LT-m)表现为无钙化的纤维软骨结构.射频紧缩对SL-d和LT-v的结构破坏较小,而对SL-v和LT-d的结构破坏较大.苦味酸天狼星红染色和Ⅲ型胶原免疫组化染色显示,射频紧缩前后仅SL-m和LT-m的Ⅰ型和Ⅲ型胶原的分布面积有显著变化.结论腕关节骨间韧带射频紧缩对SL-d和LT-v这类以致密胶原组织为主的韧带的结构破坏较小,而对SL-v和LT-d这类混含胶原和疏松结缔组织的韧带的结构破坏较大.
목적 탐토사빈긴축대완관절골간인대조직학결구적영향.방법선취6구신선성년남성시체적쌍측전비표본,우측표본진행사빈긴축치료,이좌측표본작위정상대조.장주요적완골간인대제비성골-인대-골결구,연후진행포매、절편,분별진행HE、갑분알람、고미산천랑성홍염색,이급Ⅲ형효원적면역조직화학염색,병통과도상분석연건비교염색결과.결과HE화갑분알람염색현시주월골간배측인대(SL-d)적조직결구여월삼각장측인대(LT-v)유사,이주월장측인대(SL-v)여월삼각배측인대(LT-d)유사,주월근측인대(SL-m)화월삼각근측인대(LT-m)표현위무개화적섬유연골결구.사빈긴축대SL-d화LT-v적결구파배교소,이대SL-v화LT-d적결구파배교대.고미산천랑성홍염색화Ⅲ형효원면역조화염색현시,사빈긴축전후부SL-m화LT-m적Ⅰ형화Ⅲ형효원적분포면적유현저변화.결론완관절골간인대사빈긴축대SL-d화LT-v저류이치밀효원조직위주적인대적결구파배교소,이대SL-v화LT-d저류혼함효원화소송결체조직적인대적결구파배교대.
Objective To explore the histological changes of the wrist interosseous ligaments after radiofrequency electrothermal shrinkage. Methods Six frozen fresh male adult cadaver wrist ligaments were exploited for the research. The ligaments of the right wrists were treated with radiofrequency electrothermal shrinkage with Arthrocare system, while the ligaments of the left wrists were kept as the normal control. The bone-ligament-hone samples of all the scapholunate (SL) and lunotriquetral (LT) ligaments were prepared, sectioned and then stained with the regular HE staining, toluidine blue staining, Sirius-red staining and immunohistochemistry staining of collagen Ⅲ. The image analysis software was used to compare the staining results. Results The histological structures of SL dorsal ligaments (SL-d) and LT volar ligaments (LT-v) were very similar, and the structures of SL volar ligaments (SL-v) and LT dorsal ligaments (LT-d) were also very similar. The membrane parts of both SL and LT ligaments showed the fibrous cartilage structure. The histological structures of SL-d and LT-v were much less destroyed by the radiofrequency than those of SL-v and LT-d. After radiofrequency electrothermal shrinkage, only the distribution areas of collagen Ⅰ and collagen Ⅲ were significantly changed in the membrane parts of SL and LT ligaments. Conclusion Radiofrequency electrothermal shrinkage treatment can cause minor structural damage to the collagen-dominant ligaments such as SL-d and LT-v, while it can lead to quite severe structural damage to the ligaments containing collagen and lots of loose connective tissue, such as SL-v and LT-d.