中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
43期
6940-6944
,共5页
生物材料%材料相容性%脱细胞异体真皮基质%玻璃酸钠%肌腱粘连%腱鞘重建%肌腱松解
生物材料%材料相容性%脫細胞異體真皮基質%玻璃痠鈉%肌腱粘連%腱鞘重建%肌腱鬆解
생물재료%재료상용성%탈세포이체진피기질%파리산납%기건점련%건초중건%기건송해
背景：脱细胞异体真皮被自体组织取代后即不被机体视为异物，可减少局部炎症细胞浸润，减轻炎症反应，能够达到重建腱鞘后在体内永久存留的可能性。<br> 目的：探寻脱细胞异体真皮重建腱鞘结合玻璃酸钠预防肌腱粘连松解后再粘连的效果。<br> 方法：将腕部肌腱损伤修复后粘连需要再次手术行肌腱松解的56例患者随机分为试验组(n=26)与对照组(n=30)。试验组肌腱粘连行肌腱松解后，以脱细胞异体真皮缝合成直径大于肌腱的套管状套于肌腱粘连处，使套管达到远近端未粘连部分各1 cm，缝合固定重建腱鞘两端于周围组织，套管内注射玻璃酸钠，缝合伤口；对照组肌腱松解后直接缝合伤口。术后随访半年，对比两组肌腱松解情况及再次粘连发生情况。<br> 结果与结论：试验组26例患者51根肌腱，有效49根，无效2根，有效率为96%；对照组30例患者58根肌腱，有效46根，无效12根，有效率为79%，两组有效率比较差异有显著性意义(P <0.05)。表明以脱细胞异体真皮重建腱鞘结合玻璃酸钠预防肌腱粘连松解后再粘连效果明显。
揹景：脫細胞異體真皮被自體組織取代後即不被機體視為異物，可減少跼部炎癥細胞浸潤，減輕炎癥反應，能夠達到重建腱鞘後在體內永久存留的可能性。<br> 目的：探尋脫細胞異體真皮重建腱鞘結閤玻璃痠鈉預防肌腱粘連鬆解後再粘連的效果。<br> 方法：將腕部肌腱損傷脩複後粘連需要再次手術行肌腱鬆解的56例患者隨機分為試驗組(n=26)與對照組(n=30)。試驗組肌腱粘連行肌腱鬆解後，以脫細胞異體真皮縫閤成直徑大于肌腱的套管狀套于肌腱粘連處，使套管達到遠近耑未粘連部分各1 cm，縫閤固定重建腱鞘兩耑于週圍組織，套管內註射玻璃痠鈉，縫閤傷口；對照組肌腱鬆解後直接縫閤傷口。術後隨訪半年，對比兩組肌腱鬆解情況及再次粘連髮生情況。<br> 結果與結論：試驗組26例患者51根肌腱，有效49根，無效2根，有效率為96%；對照組30例患者58根肌腱，有效46根，無效12根，有效率為79%，兩組有效率比較差異有顯著性意義(P <0.05)。錶明以脫細胞異體真皮重建腱鞘結閤玻璃痠鈉預防肌腱粘連鬆解後再粘連效果明顯。
배경：탈세포이체진피피자체조직취대후즉불피궤체시위이물，가감소국부염증세포침윤，감경염증반응，능구체도중건건초후재체내영구존류적가능성。<br> 목적：탐심탈세포이체진피중건건초결합파리산납예방기건점련송해후재점련적효과。<br> 방법：장완부기건손상수복후점련수요재차수술행기건송해적56례환자수궤분위시험조(n=26)여대조조(n=30)。시험조기건점련행기건송해후，이탈세포이체진피봉합성직경대우기건적투관상투우기건점련처，사투관체도원근단미점련부분각1 cm，봉합고정중건건초량단우주위조직，투관내주사파리산납，봉합상구；대조조기건송해후직접봉합상구。술후수방반년，대비량조기건송해정황급재차점련발생정황。<br> 결과여결론：시험조26례환자51근기건，유효49근，무효2근，유효솔위96%；대조조30례환자58근기건，유효46근，무효12근，유효솔위79%，량조유효솔비교차이유현저성의의(P <0.05)。표명이탈세포이체진피중건건초결합파리산납예방기건점련송해후재점련효과명현。
BACKGROUND:Acellular al ogeneic dermis that is replaced by autologous tissue is not considered as foreign body, and can reduce local inflammation and cellinfiltration, to achieve the possibility of permanent retention in the body after reconstruction of the tendon sheath. <br> OBJECTIVE:To evaluate the efficacy of acellular dermal matrix combined with sodium hyaluronate to prevent adhesiolysis after adhesions of tendon during the procedure of tendon sheath reconstruction. <br> METHODS:A total of 56 patients who required secondary adhesiolysis to repair tendon adhesions after repair of wrist tendon injury were randomly separated into experimental group (26 cases) and control group (30 cases). Experimental group:after tendon release, the sleeve-shaped acellular dermal matrix with a large diameter than the tendon was sewn into the site of tendon adhesions, 1 cm distant to the distal and proximal ends of non-adhesion tendon, to reconstruct the tendon sheath that was fixed at the both ends of surrounding tissue. Then, the incision was sutured after injection of sodium hyaluronate via the sleeve. Control group:after tendon release, the wound was sutured directly. Al of the patients were fol owed-up for 6 months, to compare the efficacy of tendon release and reoccurrence of adhesions. <br> RESULTS AND CONCLUSION:For 51 tendons from 26 patients in the experimental group, valid treatment was in 49 tendons and invalid in 2 tendons, with the effective rate of 96%;for 58 tendons from 30 patients in the control group, effective treatment was in 46 tendons, and invalid in 12 tendons, with the effective rate of 79%. There was a significant difference in the effective rate between the two groups (P<0.05). The reconstruction of tendon sheath using acellular dermal matrix combined with sodium hyaluronate can effectively improve adhesions after adhesiolysis.
