摘要
目的观察和探索表皮生长因子(epidermal growth factor,EGF)复合胶原膜在预防鞘管区肌腱粘连、促进肌腱内源性愈合中的作用。方法将30只10个月龄的雄性leghorn鸡随机分为A、B、C三组,每组10只。将鸡的左侧第三趾造成挤压撕脱伤模型,用改良Kessler法进行缝接。A组:肌腱缝合口包裹EGF复合胶原膜;B组:缝合口包裹单纯的胶原膜;C组:缝合口不做任何处理。4周后取材,右侧第三趾为对照组。对标本进行肉眼观察、生物力学测定、光镜和电镜等观察。结果A组肌腱粘连程度较轻,肌腱缝合段内的胶原纤维数量多,以粗大的Ⅰ型胶原为主,成纤维细胞数量少,腱细胞成熟。B组肌腱粘连程度较轻,但肌腱缝合段内的胶原纤维数量少,排列稀疏,以纤细的Ⅲ型胶原为主。C组肌腱与周围组织粘连较严重,肌腱缝合段内的胶原纤维数量较多,排列紊乱,Ⅰ、Ⅲ型胶原交错排列。结论1.EGF复合胶原膜能起到屏障肌腱外源性愈合、防止肌腱粘连的作用,但同时也明显减慢了肌腱的愈合速度。2.EGF复合可降解胶原膜,同时也加快了肌腱的内源性愈合速度,起到了较理想的防止粘连的效果。
Objective To investigate the effect of degradable collagen membrane integrated with epidermal growth factor （EGF） on preventing tendon adhesion and enhancing intrinsic tendon healing. Methods Thirty 10 months old male Leghorn chickens were randomly divided into groups A, B and C with 10 each. Flexor tendon of the third toe was lacerated and then sutured with Kessler method. In group A degradable collagen membrane integrated with EGF was wrapped around the tendon repair site in zone Ⅱ . In group B degradable collagen membrane alone was wrapped around the repair site. Group C served as control with no EGF or degradable membrane applied. Four weeks later, the specimens were evaluated by means of macroscopic observation, biomechanics test, light microscopic and electron microscopic observation. Results Mild tendon adhesion was observed in group A. There were a large amount of thick collagen Ⅰ fibers inside the sutured tendon which were closely and orderly oriented. There were fewer fibroblasts in this group. The tendon cells were more mature. Tendon adhesion was also mild in group B. However, there was less amount of collagen fibers at the tendon repair site, most of which were thin type Ⅲ collagen that were loosely oriented. In group C massive adhesion between tendon and its surrounding tissue was seen. There were a large amount of collagen fibers at the repair site containing both type Ⅰand type Ⅲ collagen which had poor alignment. Conclusion Application of degradable collagen membrane alone can block extrinsic tendon healing and prevent adhesion. It however hinders tendon healing. Application of degradable collagen membrane integrated with EGF can enhance intrinsic tendon healing and prevent adhesion.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第3期183-186,共4页
Chinese Journal of Hand Surgery
关键词
腱损伤
动物
实验
腱粘连
胶原膜
Tendon injuries
Animal,laboratory
Tendon adhesions
Collagen membrane
