CAJ | 학술논문

背景：肌腱修复术后肌腱与周围组织的粘连问题一直是临床工作中难以解决的问题之一，严重影响着患者手功能的康复。目的：介绍肌腱损伤修复术后粘连的现状及其进展。方法：检索1971年1月至2014年5月CNKI中国知网，万方医学网、PubMed数据库有关肌腱粘连预防相关的文献。英文检索词为“Tendon injury； Tendon adhesions； Progress”；中文检索词为“肌腱损伤；肌腱粘连；进展”。排除与研究目的相关性差及内容重复的研究，最终纳入40篇进行探讨。结果与结论：分析肌腱自身的特性及引起肌腱粘连的原因，总结前人在预防肌腱粘连方面采用的方法及取得的效果，分析预防肌腱粘连的各种方法及材料的利弊。预防修复治疗后肌腱粘连而又不影响肌腱愈合，要针对原因从各个方面着手，通过彻底的清创、较好的手术方式、腱周组织的显微修复、药物及阻隔材料的应用、物理疗法及修复治疗后恰当的功能锻炼等多手段的综合运用来预防术后肌腱粘连的发生。
배경：기건수복술후기건여주위조직적점련문제일직시림상공작중난이해결적문제지일，엄중영향착환자수공능적강복。목적：개소기건손상수복술후점련적현상급기진전。방법：검색1971년1월지2014년5월CNKI중국지망，만방의학망、PubMed수거고유관기건점련예방상관적문헌。영문검색사위“Tendon injury； Tendon adhesions； Progress”；중문검색사위“기건손상；기건점련；진전”。배제여연구목적상관성차급내용중복적연구，최종납입40편진행탐토。결과여결론：분석기건자신적특성급인기기건점련적원인，총결전인재예방기건점련방면채용적방법급취득적효과，분석예방기건점련적각충방법급재료적리폐。예방수복치료후기건점련이우불영향기건유합，요침대원인종각개방면착수，통과철저적청창、교호적수술방식、건주조직적현미수복、약물급조격재료적응용、물리요법급수복치료후흡당적공능단련등다수단적종합운용래예방술후기건점련적발생。
BACKGROUND:Tendon adhesions after tendon repair have been one of the problems difficult to solve in clinical practice. OBJECTIVE:To introduce the current situation and progress of the prevention of postoperative tendon adhesions. METHODS: A computer-based search of CNKI, Wanfang, PubMed databases for articles related to prevention of tendon adhesions published from January 1971 to May 2014 using the keywords of “tendon injury; tendon adhesions; progress” in Chinese and English, respectively. Repetitive content and irrelevant articles were excluded, and finaly 40 articles were included in result analysis. RESULTS AND CONCLUSION: In this paper, we analyze the characteristics of tendons and causes of tendon adhesions, summarize the methods for prevention of tendon adhesions and the therapeutic effects, and thereby analyze the pros and cons of various methods and materials for prevention of tendon adhesions. Prevention of tendon adhesions after tendon repair involves various aspects: thorough debridement, better surgical approach, microsurgical repair of tendon tissues, applications of drugs and barrier materials, physical therapy as wel as appropriate functional exercise after tendon repair. The integrated use of these means can be done to prevent the occurrence of postoperative tendon adhesions.