| 蒋玉东,关 瑛,安 刚,姜 波,韩 博,王岩松.丝素蛋白布洛芬复合凝胶预防肌腱粘连的作用研究[J].,2017,17(35):6809-6812 |
| 丝素蛋白布洛芬复合凝胶预防肌腱粘连的作用研究 |
| A Experimental Study on the Preventive Effect of Silk Fibroin Ibuprofen Combined with Gel on the Tendon Adhesion |
| 投稿时间：2017-03-14 修订日期：2017-04-10 |
| DOI：10.13241/j.cnki.pmb.2017.35.003 |
| 中文关键词: 丝素蛋白 肌腱愈合 肌腱粘连 布洛芬 |
| 英文关键词: Silk fibroin Tendon healing Tendon adhesion Ibuprofen |
| 基金项目:国家自然科学基金面上项目（81271696） |
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| 中文摘要: |
| 摘要 目的：探讨丝素蛋白布洛芬复合凝胶对肌腱粘连的预防作用及愈合后肌腱功能的影响。方法：选取体重2.5 Kg-3.5 Kg成年雄性来亨(Leghorn)鸡90只，随机分成3组，每组30只。将左足第三趾趾深屈肌腱横断后，采用改良Kessler缝合法缝合肌腱，A组动物直接缝合，B组动物在肌腱横断处周围注入丝素蛋白凝胶，然后逐层缝合，C组动物在肌腱横断处周围注入丝素蛋白布洛芬复合凝胶。在术后1、3、6周处死并取材分别进行大体实验观察、组织学观察和生物力学测定，在术后6周进行关节活动度评定。结果：术后1、3、6周，创口无感染流脓，创口愈合较好，C组肌腱粘连程度评分和肌腱功能评价显著优于B组和A组。C组细胞炎性反应较少，与周围组织粘连程度较轻，纤维组织排列较规则；B组有细胞炎性浸润反应，且与周围组织程中度粘连，纤维组织排列不规则；A组细胞炎性反应明显，与周围组织粘连较重，分界不清，纤维组织排列杂乱无序。术后3、6周，各时间点肌腱滑动距离C组最远，B组好于A组，两两比较，C组与A、B两组之间有明显差异(P<0.05)。术后3周、6周C组肌腱主动屈曲功优于B组，A组最差，两两比较，肌腱主动屈曲功比值存在差异具有统计学意义(P<0.05)。肌腱术后功能测定比较，C组趾关节活动度明显优于B组，A组最差，术后各组肌腱趾关节活动度组间差异具有统计学意义(P<0.05) 。结论：丝素蛋白布洛芬复合凝胶可以有效防止肌腱粘连，且不影响术后肌腱的功能。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the preventive effect of silk fibroin ibuprofen composite gel on the tendon adhesion and the tendon function after healing. Methods: 90 male Leghorn chickens were selected and randomly divided into 3 groups (n=30). The aver- age body weight was 2.5 Kg-3.5 Kg. The left foot third toe deep flexor tendon transection were modified Kessler suture suture tendon. Group A: direct suture; Group B: Silk fibroin gel was injected around the tendon transection, then suture by layer. Group C: Silk fibroin ibuprofen composite gel was injected around the tendon transection. The rats were sacrificed at 1, 3 and 6 weeks after operation. The general condition, histological and biomechanical changes were observed. The degree of joint activity was assessed at 6 weeks after oper- ation. Results: No wound infection pus was found at 1, 3 and 6 weeks after operation, wounds were healed well. In group C, the degree of tendon adhesion and tendon function evaluation were much better than those of group B and group A. Less inflammatory reaction and adhesion as well as more regular arrangement of fibrous tissue were observed in group C. Inflammatory infiltration reaction, irregular ad- hesion andrrangement of fibrous tissue were found in the group B. Significant inflammatory cells, heavier surrounding tissue adhesion, unclear boundaries and fibrous tissue disorder were observed in the group A. At 3 and 6 weeks after operation, the tendon slippage dis- tance were longest in group C, group B was longer than that of group A (P<0.05). At 3 and 6 weeks after operation, the work of tendon active flexion were better than that of group B, group A was the worst. Significant differences in the ratio of tendon active flexion were found between different groups(P<0.05). Compared with the postoperative functional measurement of tendon, the toe joint activity in group C was significantly better than that of group B, which was the worst in group A. Significant difference in the activity of tendon toe joint were observed between different groups after operation. Conclusion: Silk protein ibuprofen compound gel could effectively prevent the tendon adhesion, and had no effect on the function of tendon after operation. |
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