表皮生长因子复合可降解胶原膜防止鸡鞘管区肌腱粘连的实验研究.docVIP

表皮生长因子复合可降解胶原膜防止鸡鞘管区肌腱粘连的实验研究 王继宏 温树正 （内蒙古医学院第二附属医院手外二科 内蒙古 呼和浩特010030） [摘要] 目的 观察和探索表皮生长因子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月龄雄性leghorn鸡随机分为A、B、C 组，每组10只。将每只鸡的左足第三趾造成挤压撕脱伤模型，用改良Kessler缝合法缝接。A组:断端包裹复合有EGF的胶原膜；B组:断端只包裹单纯的胶原膜；C组:断端不加任何处理。术后4周,对标本进行肉眼观察、生物力学测试、光镜、电镜等观察。结果 A组肌腱粘连程度较轻，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组肌腱粘连较轻，但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重，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、可降解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, 既能起到屏障肌腱外源性愈合、防止肌腱粘连的作用，同时EGF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。 【关键词】表皮生长因子 胶原膜 肌腱粘连 实验研究 An experiment study of EGF combined with degradable collagen membrance in prevention of tendon adhesion in chicken.Wang ji-hong Wen shu-zheng .Department of hand surgery,Inner mogerlion medical collage NO 2 hospital,huhehaote ,010030,china . Objective To study the adhesion-preventing effect of epidermal growth factor(EGF)combined with degradable collagen membrane，and its effect of improving tendon regeneration inside . Methods　 Thirty ten-month old fowl were randomly divided into groups A,B and C (10 each group).Cut off the flexor tendon in the third toe then suture it .In groupA,sutured flexor tendon in zone Ⅱwere encapsulated with EGF combined with degradable collagen membrane; in group B,sutured flexor tendon were encapsulated with degradable membrane alone; in group C, no EGF or degradable membrane applied. Four weeks later, the specimens were evaluated by means of macroscopic observation, vitodynamics test, light microscope and electron microscope. Results ①In group of A ,There were a large amount of collogen Ⅰinside the sutured tendon ,they were closely and and line up in order.The amount of collagen-fibronectin was less than that in groups C (P0.01) and the adhesion obviously was less than the control tendons, The peripheral tissue in group A almost remains as the formal loose connective tissue,it was in the advanced stage of tendon regeneration. ②In group A ,there were a large amount of collogen Ⅲ