摘要
目的探讨局部单次使用bFGF及5-氟尿嘧啶(5-fluorouracil,5-FU)促进屈肌腱愈合和防止粘连形成的效果。方法成年雄性来亨鸡90只,体重3.0～3.5 kg,随机分为3组,每组30只。显露实验动物右爪第3趾趾深屈肌腱,A组切断肌腱后在断端使用纤维蛋白封闭剂(fibrin sealant,FS)0.6μL,原位缝合修复横断肌腱;B组肌腱断端使用bFGF和FS混合物0.6μL(内含bFGF 500 ng),原位缝合修复横断肌腱;C组在肌腱切断前先用5-FU浸泡肌腱,其余处理同B组。术后观察实验动物一般情况,于1、2、4、8周每组各取6只鸡第3趾行大体及组织学观察,术后8周每组另取6只鸡第3趾行生物力学测定。结果术后实验动物全部存活至实验完成,无肌腱断裂发生。术后8周,A组肌腱粘连程度与B、C组比较,差异均无统计学意义(P>0.05);C组粘连程度较B组轻(P<0.05)。组织学观察示,术后1、2、4周A组腱鞘、腱外膜及腱实质的成纤维细胞数均较B组少(P<0.05);C组在腱鞘、腱外膜少于A、B组(P<0.05),而在腱实质比A组多(P<0.05),与B组比较差异无统计学意义(P>0.05)。术后8周,各组间成纤维细胞数比较差异均无统计学意义(P>0.05)。术后4、8周A组腱鞘、腱外膜及腱实质的胶原纤维含量均少于B组(P<0.05)。在腱鞘、腱外膜,术后4周A组多于C组(P<0.05),术后8周两组间差异无统计学意义(P>0.05);在腱实质,各时间点A组均少于C组(P<0.05)。各时间点B组在腱鞘、腱外膜的胶原纤维含量均多于C组(P<0.05),而在腱实质两组间差异无统计学意义(P>0.05)。生物力学测定:A、B、C组肌腱滑动距离分别为(3.51±0.56)、(2.84±0.42)、(4.56±0.59)mm,屈曲功分别为(14.08±1.85)、(20.62±3.52)、(10.91±1.53)N.mm,最大抗拉力分别为(11.26±1.83)、(15.02±2.20)、(14.4±1.57)N。各组肌腱滑动距离和屈曲功比较,差异均有统计学意义(P<0.05);B、C组间最大抗拉力差异无统计学意义(P>0.05),但均大于A组(P<0.05)。结论 局部单次
Objective To assess the effect of basic fibroblast growth factor （bFGF） and 5-fluorouracil （5-FU） applied topically on the tendon adhesion and the healing process after the flexor tendon repair in Leghorn chickens. Methods Ninety male Leghorn chickens （weighing 3.0-3.5 kg） were randomly divided into 3 groups, with 30 chickens in each group. The flexor digitorum profundus tendons of the third right toes were transected and sutured directly. The repair site in group A was given 0.6 pL fibrin sealant （FS）. In group B, the repair site was given 0.6 pL FS containing 500 ng bFGF. In group C, before the tendons were transected, they had been soaked in 5-FU solution, and then the same treatment as group B was given. Six specimens of the third toe were harvested to perform the macroscopical and histological examinations at 1, 2, 4, and 8 weeks, respectively, and to perform the biomechanical test at 8 weeks. Results All animals survived until the experiment was completed. All incisions healed smoothly. No rupture occurred in the reparied tendon. At 8 weeks, the adhesion degree was lighter in group C than in group B （P 〈 0.05）, but there was no significant difference in the adhesion degree between group A and groups B, C （P 〉 0.05）. At 1, 2, and 4 weeks after operation, the number of fibroblast cells of group A was significantly less than that of group B （P 〈 0.05）, and the number of fibroblast cells of group C was significantly less than that of group A and group B in the tendon sheath and epitenon （P 〈 0.05）; however, it was significantly more than that of group A in the tendon parenchyrna （P 〈 0.05）, and no significant difference was observed when compared with that of group B （P 〉 0.05）. At 8 weeks, no difference was found among 3 groups （P 〉 0.05）. The collagen fiber content of group A was significantly less than that of group B at 4 and 8 weeks （P 〈 0.05）. In the sheath and epitenon, the collagen fiber content of group A was significantly more than that o
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第6期711-717,共7页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肌腱愈合
肌腱粘连
屈肌腱
BFGF
5-氟尿嘧啶
鸡
Tendon healing Tendon adhesion Flexor tendon Basic fibroblast growth factor 5-Fluorouracil Chicken
