CAJ | 학술논문

目的评估猪小肠粘膜下层预防肌腱粘连的效果.方法取成年雄性来亨鸡54只,随机分成3组,每组18只.切除鸡右足第3趾Ⅱ区的腱鞘1.0 cm,采用猪小肠粘膜下层修复为实验组(B组),腱鞘缺损原位修复为对照组(A组),不修复为腱鞘缺损组(C组).术后4周,3组均行关节总活动度(total active motion,TAM)测定、肌腱滑移距离(tendon sliding distance,TSD)测定、HE染色组织学观察、Nyska法粘连度评定、腱鞘滑膜细胞免疫组织化学S-P法染色观察、腱鞘滑膜细胞计数,从而评价猪小肠粘膜下层预防肌腱粘连的效果.结果术后4周,TAM测定:A组为143.33±20.93,B组为142.72±16.16,C组为105.78±8.97;TSD测定:A组为1.12±0.12,B组为1.11±0.11,C组为0.99±0.11;Nyska法粘连度评分:A组为0.50+ 0.51,B组为0.72+0.57,C组为1.89+ 0.76;滑膜细胞计数:A组为119.33±33.55,B组为91.50±21.88,C组为33.17±22.41.A、B两组与C组比较差异均有统计学意义(P＜0.05),B组与A组比较差异无统计学意义(P＞0.05).HE染色组织学观察可见A、B两组肌腱与腱鞘之间的空隙较C组明显.免疫组织化学S-P法染色观察可见A、B组大量滑膜细胞,明显多于C组.结论猪小肠粘膜下层修复缺损的腱鞘能有效预防肌腱粘连.
목적 평고저소장점막하층예방기건점련적효과.방법 취성년웅성래형계54지,수궤분성3조,매조18지.절제계우족제3지Ⅱ구적건초1.0 cm,채용저소장점막하층수복위실험조(B조),건초결손원위수복위대조조(A조),불수복위건초결손조(C조).술후4주,3조균행관절총활동도(total active motion,TAM)측정、기건활이거리(tendon sliding distance,TSD)측정、HE염색조직학관찰、Nyska법점련도평정、건초활막세포면역조직화학S-P법염색관찰、건초활막세포계수,종이평개저소장점막하층예방기건점련적효과.결과 술후4주,TAM측정:A조위143.33±20.93,B조위142.72±16.16,C조위105.78±8.97;TSD측정:A조위1.12±0.12,B조위1.11±0.11,C조위0.99±0.11;Nyska법점련도평분:A조위0.50+ 0.51,B조위0.72+0.57,C조위1.89+ 0.76;활막세포계수:A조위119.33±33.55,B조위91.50±21.88,C조위33.17±22.41.A、B량조여C조비교차이균유통계학의의(P＜0.05),B조여A조비교차이무통계학의의(P＞0.05).HE염색조직학관찰가견A、B량조기건여건초지간적공극교C조명현.면역조직화학S-P법염색관찰가견A、B조대량활막세포,명현다우C조.결론 저소장점막하층수복결손적건초능유효예방기건점련.
Objective To assess the effectiveness of tendon adhesion prevention using small intestine submucosa (SIS).Methods Fifty-four adult male Leghorn chickens were randomly divided into three groups,with 18 each.A piece of tendon sheath measuring 1.0 cm was excised in zone Ⅱ of flexor tendon of the right 3rd toe.According to group assignment,the tendon sheath was repaired by in situ reattachment of the excised sheath (control group,A),by SIS (experimental group,B),or left unrepaired (tendon sheath defect group,C).After four weeks,animals in all three groups were subject to total active motion (TAM) measurement,tendon gliding distance (TGD) measurement,histological observation with HE staining,Nyska adhesion assessment,SP immunohistochemical staining of tendon sheath synovial cells,and tendon sheath synovial cell count.These parameters were compared among the groups to evaluate the effect of SIS in preventing tendon adhesion.Results Four weeks postoperatively,TAM was 143.33 ± 20.93 degrees in group A,142.72 ± 16.16 degrees in group B,and 105.78 ± 8.97 degrees in group C.TGD was 1.12 ± 0.12 cm in group A,1.11 ± 0.11 cm in group B,and 0.99 ± 0.11 cm in group C.Nyska's adhesion score was 0.50 ± 0.51 in group A,0.72 ± 0.57 in group B,and 1.89 ± 0.76 in group C.Synovial cell count was 119.33 ± 33.55 in group A,91.50 ± 21.88 in group B,and 33.17 ± 22.41 in group C.The differences between group A and group C and between group B and group C were significant (P ＜ 0.05).Between group B and group A,the difference was not statistically significant (P ＞ 0.05).HE staining showed more visible gap between the tendon and tendon sheath in groups A and B than in group C.Immunohistochemical staining revealed significantly higher number of synovial cells in groups A and B comparing to group C.Conclution Repairing tendon sheath defect with SIS can effectively prevent tendon adhesion.