CAJ | 학술논문

背景：近年来关于防治肌腱粘连的各种观点与方法层出不穷，目前尚没有一种方法能完全有效的防治肌腱粘连。 　　目的：通过广泛查阅近年来肌腱粘连的相关文献，总结阐述肌腱粘连的原因、机制，并介绍几种较为热门的预防方法。 　　方法：检索1992年1月至2014年1月PubMed数据库及维普中文科技数据库文献。英文检索词为“Tendon Injuries；tendon adhesion；Healing；mechanisms；prevention”，中文检索词为“腱损伤；肌腱粘连；肌腱愈合；机制；预防”。纳入与肌腱粘连的原因愈合方式及预防肌腱粘连的相关文献。纳入41篇文献进行分析探讨。 　　结果与结论：研究认为肌腱粘连与肌腱愈合机制之间有密切关联。肌腱的愈合过程中包括肌腱的内源性愈合和外源性愈合，内源性愈合肌腱表面的纤维细胞经过自身增殖促进肌腱的愈合；外源性愈合是由肌腱周围组织通过生成肉芽形成瘢痕愈合。不同的肌腱缝合方法同样会造成肌腱修复过程的迥异，抗张力大，且表面平滑的缝合方法被认为是减轻肌腱粘连的有效手段。通过增加或减少相应大分子物质可以抑制外源性愈合。高分子化合物不仅具有屏障作用同时具有促进内源性愈合的作用。将基因和间充质干细胞导入肌腱，有利于肌腱的愈合，标志着细胞治疗和基因转移已开始成为目前促进肌腱的愈合的新途径。
배경：근년래관우방치기건점련적각충관점여방법층출불궁，목전상몰유일충방법능완전유효적방치기건점련。 　　목적：통과엄범사열근년래기건점련적상관문헌，총결천술기건점련적원인、궤제，병개소궤충교위열문적예방방법。 　　방법：검색1992년1월지2014년1월PubMed수거고급유보중문과기수거고문헌。영문검색사위“Tendon Injuries；tendon adhesion；Healing；mechanisms；prevention”，중문검색사위“건손상；기건점련；기건유합；궤제；예방”。납입여기건점련적원인유합방식급예방기건점련적상관문헌。납입41편문헌진행분석탐토。 　　결과여결론：연구인위기건점련여기건유합궤제지간유밀절관련。기건적유합과정중포괄기건적내원성유합화외원성유합，내원성유합기건표면적섬유세포경과자신증식촉진기건적유합；외원성유합시유기건주위조직통과생성육아형성반흔유합。불동적기건봉합방법동양회조성기건수복과정적형이，항장력대，차표면평활적봉합방법피인위시감경기건점련적유효수단。통과증가혹감소상응대분자물질가이억제외원성유합。고분자화합물불부구유병장작용동시구유촉진내원성유합적작용。장기인화간충질간세포도입기건，유리우기건적유합，표지착세포치료화기인전이이개시성위목전촉진기건적유합적신도경。
BACKGROUND:Various views and methods for prevention of tendon adhesion have emerged in recent years;however, there is stil no method that can effectively prevent tendon adhesion. OBJECTIVE:To conclude the etiology and pathogenesis of tendon adhesion and to introduce several popular methods for prevention of tendon adhesion by means of reviewing relevant literatures published in recent years. METHODPubMed database and VIP database were searched for articles related to etiology, healing method and prevention of tendon adhesion published from January 1992 to January 2014 using the keywords of“tendon Injuries;tendon adhesion;healing;mechanisms;prevention”in English and Chinese, respectively. Final y, 41 articles were included in result analysis. RESULTS AND CONCLUSION:Studies have suggested that there is a close correlation between the mechanisms of tendon adhesion and tendon healing. Endogenous healing and exogenous healing are contained in the process of tendon healing. Endogenous healing is that fiber cells on the tendon surface promote tendon healing through their own proliferation. Exogenous healing is to form scar tissues through granulation generated by the surrounding tissues of tendons. Different suture methods can also cause different tendon repair processes. The suture method with strong tensile strength and smooth surface is considered to be an effective mean to reduce tendon adhesion. To inhibit exogenous healing, we can increase or decrease the corresponding macromolecular substances. Polymer compounds cannot only be the barrier but also can promote endogenous healing. By introducing the gene and mesenchymal stem cells into the tendon, we can promote tendon healing, which means the celltherapy and gene transfer have become the new way to promote the healing of tendon.