CAJ | 학술논문

目的：探讨可以减轻鸡肌腱粘连的功能锻炼的最佳次数、强度。方法选取实验动物来亨鸡60只，随机等分3组，离断左侧足趾第3深屈趾肌腱，手术修复，在膝关节处屈趾肌腱近端留置长线，缝合后绷带外固定。每组每次牵拉6回，足趾屈曲1／4圆弧，牵拉力2 N 锻炼，A 组每天锻炼1次，B 组2次，C 组3次；右侧同时切断肌腱后给予修复，不予锻炼，作为对照组。术后28 d ，弹簧秤2 N 牵拉留置线，记录肌腱滑动距离，切开肌腱缝合处，观察大体及组织学标本并作统计学分析。结果实验动物60只，A 组存活18只，断裂1只，占5．56％，汤氏分级Ⅰ～Ⅳ级分别为1、2、4、10只。 B 组存活17只，断裂1只，占5．88％，汤氏分级Ⅰ～Ⅳ级分别为12、2、1、1只，C 组存活16只，再次断裂15只，断裂率为93．75％，汤氏分级Ⅰ级。自体对照组 A′B′C′均呈汤氏分级Ⅳ级，样本数分别为19、19、17只。在大体粘连程度上 A 、B 组差异无统计学意义（P＞0．05），而 A 、B 两组与 C 组差异均有统计学意义（P＜0．05），实验组与对照组差异均有统计学意义（P＜0．05）。肌腱滑动距离统计，A 组平均滑动距离（3．01±1．58）mm ，B组（6．72±2．02）mm ，A 、B 两组滑动距离差异有统计学意义（P＜0．05）。 C 组仅一个样本未断裂，不能参与统计。 A 、B 组断裂率差异无统计学意义（α′＝0．0125，PAB ＞α′）。结论适度功能锻炼可有效减轻鸡肌腱粘连。
목적：탐토가이감경계기건점련적공능단련적최가차수、강도。방법선취실험동물래형계60지，수궤등분3조，리단좌측족지제3심굴지기건，수술수복，재슬관절처굴지기건근단류치장선，봉합후붕대외고정。매조매차견랍6회，족지굴곡1／4원호，견랍력2 N 단련，A 조매천단련1차，B 조2차，C 조3차；우측동시절단기건후급여수복，불여단련，작위대조조。술후28 d ，탄황칭2 N 견랍류치선，기록기건활동거리，절개기건봉합처，관찰대체급조직학표본병작통계학분석。결과실험동물60지，A 조존활18지，단렬1지，점5．56％，탕씨분급Ⅰ～Ⅳ급분별위1、2、4、10지。 B 조존활17지，단렬1지，점5．88％，탕씨분급Ⅰ～Ⅳ급분별위12、2、1、1지，C 조존활16지，재차단렬15지，단렬솔위93．75％，탕씨분급Ⅰ급。자체대조조 A′B′C′균정탕씨분급Ⅳ급，양본수분별위19、19、17지。재대체점련정도상 A 、B 조차이무통계학의의（P＞0．05），이 A 、B 량조여 C 조차이균유통계학의의（P＜0．05），실험조여대조조차이균유통계학의의（P＜0．05）。기건활동거리통계，A 조평균활동거리（3．01±1．58）mm ，B조（6．72±2．02）mm ，A 、B 량조활동거리차이유통계학의의（P＜0．05）。 C 조부일개양본미단렬，불능삼여통계。 A 、B 조단렬솔차이무통계학의의（α′＝0．0125，PAB ＞α′）。결론괄도공능단련가유효감경계기건점련。
Objective To discover the best physical training way including frequency and intensity each day ,and to guide pa‐tients to get the best cure .Methods Totally 60 chicken ,which were randomly divided into 3 groups ,20 for each ,the deep flexor tendon of the third left toes were found ,repairing after cut them off .Flexor tendon proximal were found by making knees incision then indwelling long silk line .External fixation bandage were used .Their left toes were accepted physical training ,Training stand‐ards :6 pulling backs each time ,toe flexion 1/4 arc ,but less than 2 N .For group A ,exercised once a day ,twice a day for group B , three times a day for group C .Right ones were consider as control group weren′t processed after operation .28 days later ,tendon distance was recorded by using 2 N pulling forces at tendon proximal with aspiring balance .Gross specimen was observed and histo‐logical specimens using Tang Jinen classification method to classify adhesions ,and the dates were analyzed by statistics SPSS 19 .0 . Results Group A remaining of 18 ,rate of 5 .56% ,grade Ⅰ of 1 ,Ⅱ of 2 ,Ⅲ of 4 ;Ⅳ of 10 .Group B remaining of 17 ,rate of 5 .88% , grade Ⅰ of 12 ,Ⅱ of 2 ,Ⅲ of 1 ,Ⅳ of 1 .group C remaining of 16 ,15 toes broke again ,fracture rate was 93 .75 % ,grade Ⅰ of 1 ,con‐trol group were grade Ⅳ .Between group A and B there were no significant differences in degree of adhesion(P> 0 .05) .Group A and Cs′ differences were statistically tested (P< 0 .05) .So were group B and C (P< 0 .05) .The average sliding distance for group A was (3 .01 ± 1 .58) mm ,(6 .72 ± 2 .02) mm for group B ,group C only got one sample ,8 .60mm ,and it was out of statistics .Be‐tween group A and B ,difference resulting from its tendon sliding after statistical tests(P< 0 .05) .For fracture rate ,Group A and B no significant difference was found(α′ = 0 .012 5 ,PAB > α′) .Conclusion Physical training can reduce chicken′s tendon adhesion effectively .