中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2011年
12期
1624-1626,1630
,共4页
孙士温%陆永江%孙海军%吴迎波%杜永军%赵胡瑞
孫士溫%陸永江%孫海軍%吳迎波%杜永軍%趙鬍瑞
손사온%륙영강%손해군%오영파%두영군%조호서
环氧化酶2抑制剂/药理学%黏膜/药物作用%肌腱病/预防和控制%伤口愈合/药物作用
環氧化酶2抑製劑/藥理學%黏膜/藥物作用%肌腱病/預防和控製%傷口愈閤/藥物作用
배양화매2억제제/약이학%점막/약물작용%기건병/예방화공제%상구유합/약물작용
Cyclooxygenase 2 inhibitors/PD%Mucous membrane/DE%Tendinopathy/PC%Wound healing/DE
目的 探讨塞来昔布对肌腱粘连及肌腱愈合的影响.方法 健康新西兰大白兔54只,随机分为3组:塞来昔布组、布洛芬组、生理盐水组.建立肌腱断裂模型,术后塞来昔布组口服塞来昔布[20 mg/(kg·d)]、布洛芬组口服布洛芬[75 mg/(kg·d)]、生理盐水组予生理盐水.术后4、8周取材,分别进行大体观察、组织学观察、生物力学检测.结果 (1)大体观察:塞来昔布组及布洛芬组随着时间的推移,肌腱均塑形好,表面光滑,并覆以薄膜样组织,容易分离,而生理盐水组随着时间的推移,肌腱与周围组织中等致密粘连,分离较困难；(2)组织学观察:随着时间的推移,塞来昔布组及布洛芬组肌腱与腱周组织之间间隙逐渐清楚,成熟纤维细胞逐渐排列规则且方向一致；而生理盐水组肌腱与腱周组织之间也逐渐有间隙,但成纤维细胞较多且排列不规则；(3)生物力学测定:①肌腱滑动阻力测定:术后4、8周时,塞来昔布组、布洛芬组与生理盐水组肌腱滑动阻力比较,其差异均有统计学意义(0.354 ±0.078/0.382 ±0.121 vs 0.521 ±0.126,P＜0.05；0.075±0.035/0.097±0.043 vs0.414 ±0.110,P＜0.01)；②肌腱最大拉伸断裂强度:术后4、8周时塞来昔布组、生理盐水组与布洛芬组肌腱最大拉伸断裂强度比较,其差异均有统计学意义(36.812 ±6.388 vs 24.899±4.667,P＜0.05;34.297±8.132 vs 24.899±4.667,P＜0.01; 54.515±4.688/59.037±6.606 vs 42.418±5.594,P＜0.01).结论 塞来昔布能有效预防肌腱粘连,且不影响肌腱愈合.
目的 探討塞來昔佈對肌腱粘連及肌腱愈閤的影響.方法 健康新西蘭大白兔54隻,隨機分為3組:塞來昔佈組、佈洛芬組、生理鹽水組.建立肌腱斷裂模型,術後塞來昔佈組口服塞來昔佈[20 mg/(kg·d)]、佈洛芬組口服佈洛芬[75 mg/(kg·d)]、生理鹽水組予生理鹽水.術後4、8週取材,分彆進行大體觀察、組織學觀察、生物力學檢測.結果 (1)大體觀察:塞來昔佈組及佈洛芬組隨著時間的推移,肌腱均塑形好,錶麵光滑,併覆以薄膜樣組織,容易分離,而生理鹽水組隨著時間的推移,肌腱與週圍組織中等緻密粘連,分離較睏難；(2)組織學觀察:隨著時間的推移,塞來昔佈組及佈洛芬組肌腱與腱週組織之間間隙逐漸清楚,成熟纖維細胞逐漸排列規則且方嚮一緻；而生理鹽水組肌腱與腱週組織之間也逐漸有間隙,但成纖維細胞較多且排列不規則；(3)生物力學測定:①肌腱滑動阻力測定:術後4、8週時,塞來昔佈組、佈洛芬組與生理鹽水組肌腱滑動阻力比較,其差異均有統計學意義(0.354 ±0.078/0.382 ±0.121 vs 0.521 ±0.126,P＜0.05；0.075±0.035/0.097±0.043 vs0.414 ±0.110,P＜0.01)；②肌腱最大拉伸斷裂彊度:術後4、8週時塞來昔佈組、生理鹽水組與佈洛芬組肌腱最大拉伸斷裂彊度比較,其差異均有統計學意義(36.812 ±6.388 vs 24.899±4.667,P＜0.05;34.297±8.132 vs 24.899±4.667,P＜0.01; 54.515±4.688/59.037±6.606 vs 42.418±5.594,P＜0.01).結論 塞來昔佈能有效預防肌腱粘連,且不影響肌腱愈閤.
목적 탐토새래석포대기건점련급기건유합적영향.방법 건강신서란대백토54지,수궤분위3조:새래석포조、포락분조、생리염수조.건립기건단렬모형,술후새래석포조구복새래석포[20 mg/(kg·d)]、포락분조구복포락분[75 mg/(kg·d)]、생리염수조여생리염수.술후4、8주취재,분별진행대체관찰、조직학관찰、생물역학검측.결과 (1)대체관찰:새래석포조급포락분조수착시간적추이,기건균소형호,표면광활,병복이박막양조직,용역분리,이생리염수조수착시간적추이,기건여주위조직중등치밀점련,분리교곤난；(2)조직학관찰:수착시간적추이,새래석포조급포락분조기건여건주조직지간간극축점청초,성숙섬유세포축점배렬규칙차방향일치；이생리염수조기건여건주조직지간야축점유간극,단성섬유세포교다차배렬불규칙；(3)생물역학측정:①기건활동조력측정:술후4、8주시,새래석포조、포락분조여생리염수조기건활동조력비교,기차이균유통계학의의(0.354 ±0.078/0.382 ±0.121 vs 0.521 ±0.126,P＜0.05；0.075±0.035/0.097±0.043 vs0.414 ±0.110,P＜0.01)；②기건최대랍신단렬강도:술후4、8주시새래석포조、생리염수조여포락분조기건최대랍신단렬강도비교,기차이균유통계학의의(36.812 ±6.388 vs 24.899±4.667,P＜0.05;34.297±8.132 vs 24.899±4.667,P＜0.01; 54.515±4.688/59.037±6.606 vs 42.418±5.594,P＜0.01).결론 새래석포능유효예방기건점련,차불영향기건유합.
Objective To explore the effect of celecoxib on the tendon adhesion and healing after anastomosis.Methods 54 New Zealand white rabbits were randomly assigned to one of 3 ( celecoxib,ibuprofen,and saline) groups.The deep flexor tendon was transected,followed by a primary repair.The care was begun the day after surgery and was continually provided for 14 days.Celecoxib was given[20 mg/( kg · d) ],ibuprofen was given [75 mg/( kg · d) ],or the same volume of saline solution was given respectively.At the 4th and 8th week the animals were killed and assessed by general observation,histologically observation,and biomechanical testing.Results General observation,celecoxib group and ibuprofen group showed good shape of tendons,smooth surface,and covered with a film - like tissue,and it was easy to be separated.Saline group showed that tendon and surrounding tissue medium had dense adhesions,and it was difficult to be separated.Histologically observation showed between tendon and paratenon had clear gap in celecoxib and ibuprofen group.The mature fiber cells gradually arranged rules and in the same direction.Saline between the tendon and paratenon gradually emerged a gap,but more fibroblasts and arranged in irregular.Biomechanical testing showed that tendon sliding resistance appeared in celecoxib and ibuprofen group.Compared with saline group,the differences were statistically significant (0.354 ± 0.078/0.382 ±0.121 vs 0.521 ±0.126,P ＜0.05;0.075 ±0.035/0.097 ±0.043 vs 0.414 ±0.110,P ＜0.01).UTS (ultimate tensile strength had statistical significance among celecoxib,saline groups and ibuprofen group.(36.812 ±6.388 vs 24.899 ±4.667,P ＜0.05;34.297 ±8.132 vs 24.899 ±4.667,P ＜0.01 ;54.515 ±4.688/59.037 ± 6.606 vs 42.418 ± 5.594,P ＜ 0.01 ).Conclusions Celecoxib can effectively prevent tendon adhesion,and does not affect the tendon healing.
