迪康可吸收生物膜论文：迪康可吸收生物膜 屏障作用 肌腱粘连 内源性愈合 主动活动度 生物力学.doc

【关键词】迪康可吸收生物膜 屏障作用 肌腱粘连 内源性愈合 主动活动度 生物力学【英文关键词】Barrier function tendon adhesions endogenous healing active degree biomechanics迪康可吸收生物膜论文：川芎嗪注射液联合可吸收生物膜预防术后肌腱粘连的实验研究【中文摘要】通过实验研究,探讨川芎嗪注射液与可吸收生物膜联合应用预防肌腱及组织粘连的有效性。方法：从86只健康成年三黄鸡选取78只,雌雄各半,采用随机数字表的方法分为对照组(A组)、可吸收生物膜组(B组)、川芎嗪+可吸收生物膜组(C组),每组26只。参照Sungur N的造模方法行第三足趾屈趾深肌腱游离并切断1/2,断端吻合修复造模。B、C组应用可吸收医用膜(成都迪康中科生物医学材料有限公司)包绕腱周组织,C组用川芎嗪注射液在肌腱吻合口周围注射,完全浸透可吸收生物膜。关闭伤口,无菌敷料包扎。术后2、4、6、8周取材,各组实验动物分别进行大体观察,生物力学测定和组织学检测,透射电镜观察,并对各组数据进行统计学分析。结果：(1)大体观察：术后2、4、6、8周肌腱粘连程度分级,B组、C组动物肌腱缝合处始终保持光滑；A组肌腱缝合处形成大量粗大粘连带。B组与C组比较有统计学差异(P0.05),B组、C组与A组比较有显著统计学差异(P0.01),B、C组粘连程度明显小于A组。(2)生物力学测定：关节屈曲角度：术后2、4、6、8周,各组关节屈曲角度比值间差异有显著性意义(P0.01)；B、C组屈曲角度比值均大于同一时相的A组,差异有显著性意义(P0.01),C组屈曲角度比值大于同一时相的B组,差异有统计学意义(P0.05)。肌腱滑动距离：术后2、4、6、8周,三组肌腱滑动距离比值间差异均有统计学意义(P0.05)。三个时相上C组均优于A组、B组,差异有显著性意义(P0.01)。肌腱最大抗断裂载荷：术后2、4周,三组肌腱最大抗断裂载荷比值间差异均有统计学意义(P0.05)。三个时相上B、C组均优于A组,差异有显著性意义(P0.05)。术后6、8周各组间最大抗断裂载荷比值间差异无显著性意义(P0.05)。(3)组织学检测：HE染色：术后2、4、6周,B、C组胶原纤维排列较A组整齐,淋巴细胞浸润不明显。术后8周：A、B、C组肌腱断端间差异不明显,均可见胶原纤维连接,其间可见成熟的腱细胞,排列规则,呈波浪状。Masson染色：术后2、4周C组胶原纤维排列规则,未见明显增生,B组显示大量的腱周成纤维细胞增生,胶原纤维增生明显并趋向规则排列,A组胶原纤维排列紊乱,胶原束成熟度不一；6、8周B、C组胶原纤维增多,排列规则,胶原束直径一致,A组则胶原纤维不规则,胶原束直径大小不一。(4)透射电镜观察：术后4周,B、C组较A组成纤维细胞数量多且分化活动明显,细胞器增多,胶原原纤维排列趋于规则。术后8周A组胶原排列紊乱,B组仍可见部分成纤维细胞呈现活跃,周围胶原纤维排列尚规则；C组成纤维细胞分化成熟,胶原纤维数量及排列均优于A、B组。结论：1.迪康可吸收生物膜与川芎嗪均可有效预防肌腱粘连；迪康可吸收生物膜与川芎嗪综合应用在肌腱粘连的防治中效果显著,其作用机制主要为屏障性物理阻隔作用,降低外源性愈合发生机率并加速肌腱内源性愈合,其使用方法简单且吸收性良好,是一种理想的预防肌腱粘连的新方法。2.迪康可吸收生物膜与川芎嗪综合应用预防肌腱粘连疗效确切,其操作方法简单、安全性较高,为防止组织粘连特别是肌腱领域开辟了新途径。【英文摘要】:Experimental study to explore the ligustrazine liquid and can absorb the biofilm in combination to prevent the effectiveness of the tendons and tissue adhesion for clinical adhesions.Methods:78selected from86healthy and adult sanhuang, using a random number table is divided into control group (group A), can absorb the biofilm (B group), TMP+absorption of biological membrane group (C group)(n=26). Modeling method of the third toe of the line reference Sungur N flexor digitorum profundus tendon free and cut off1/2, stump anastomosis repair modeling. B, Group C applications absorbable medical film (Chengdu Ducam in the Division of Biomedical Materials Co., Ltd.) surrounding the tendon tissues, anastomotic C tetramethylpyrazine injection in the tendon around the injection completely soaked absorbable biofilm. Wound closure, sterile dressing. Drawn2,4,6and8weeks after each group of experimental animals were observed for gross biomechanical test and histology, transmission electron microscopy, and each group data were statistically analyzed.Results:(1) general observation:2,4,6and8weeks after the degree of tendon adhesion classification, group B, group C animals tendon suture always maintain smooth; group A suture formed a large number of thick adhesions, more significant difference (P0.05) in group B and group C, group C and group A, statistically significant differences (P0.01), Group B statistically significant differences (P0.01) in group B, C, adhesion was significantly less than in group A compared with group A Determination of (2) Biomechanics:flexion angle:2,4,6and8weeks postoperatively, the flexion angle ratio was significant (P0.01); group B, C, flexion angle ratio is greater than the same phase difference between group A There are significant differences (P0.01), while group B, group C relative to the flexion angle ratio is greater than the same difference was statistically significant (P0.05). Tendon sliding distance:2,4,6and8weeks after surgery, the difference between the three groups of tendon sliding distance ratio were statistically significant (P0.05). On the three-phase C were superior to group A, group B, the difference was significant (P0.01). Maximum resistance to fracture load in tendon:experimental toe and the contralateral normal toe fracture resistance load and the ratio of to see the text in the table. The statistics showed:2,4weeks after surgery, three groups of tendon largest difference between the ratio of the resistance to fracture load were statistically significant (P0.05). Three phases on the B, Group C were better than group A, the difference was statistically significant (P0.05).8weeks after surgery, maximum resistance to fracture load ratio difference was not significant significance (P0.05).(3) histological detection:HE staining:2,4and6weeks after surgery, B, C collagen fibers arranged in group A neat, lymphocyte infiltration was not obvious. After8weeks:A, B, C, tendon stump no significant differences are visible collagen fibers that connect, during which visible mature tendon cells, regularly arranged, wavy. Masson staining:4weeks after surgery in group C the collagen fiber arrangement rules, no significant proliferation group B show a lot of tendon weeks fibroblast proliferation, collagen fibers was significantly and tends to the regular arrangement of collagen fibers A disordered arrangement of collagen different beam maturity.(4) transmission electron microscopy:4weeks after surgery, B, Group C than A number of fibroblasts and differentiation activities significantly increased organelles, collagen fibril arrangement tends to rule.8weeks after surgery in group A collagen derangement, group B is still visible part into showing active fibroblasts around the collagen fibers still rules; C, composed of fiber cell differentiation and maturation, the number and arrangement of the collagen fibers are superior to group A, B.Conclusion:1. Ducam can absorb Biomembrane and tetramethylpyrazine can be effective in preventing tendon adhesion; the DICON can absorb the comprehensive application of Biomembrane and tetramethylpyrazine significant effect in the prevention of tendon adhesion, and its mechanism for the physical barrier effect of the barrier resistance, reduce the exogenous healing incidence and accelerate tendon endogenous healing, its use is simple and good absorbency, is an ideal new method for the pr