發(fā)布時間：2018-03-26 16:29

  本文選題：移植　切入點(diǎn)：自體　出處：《中國組織工程研究》2017年30期

【摘要】：背景:最新研究表明,肩袖補(bǔ)片可降低肌腱和骨之間的張力,可為生長因子和細(xì)胞生長提供制成的附著點(diǎn),促進(jìn)肩袖止點(diǎn)的生物學(xué)重建,然而何種材料作為肩袖補(bǔ)片是最安全有效的尚無明確共識。目的:探討自體骨膜補(bǔ)片加強(qiáng)修復(fù)對肩袖腱骨愈合的影響。方法:取48只新西蘭白兔,建立單側(cè)肩袖急性肩袖損傷模型,隨機(jī)分2組修復(fù),對照組進(jìn)行單純縫合固定修復(fù),實驗組在對照組基礎(chǔ)上進(jìn)行自體骨膜補(bǔ)片加強(qiáng)修復(fù),修復(fù)后4,8,12周取肱骨近端標(biāo)本,進(jìn)行組織學(xué)觀察與生物力學(xué)測試。結(jié)果與結(jié)論:①組織學(xué)觀察:實驗組修復(fù)后4周可見大量膠原纖維連接和炎性細(xì)胞浸潤,間充質(zhì)細(xì)胞增生明顯,有少量軟骨細(xì)胞;修復(fù)后8周可見膜內(nèi)化骨,大量新生軟骨細(xì)胞;修復(fù)后12周可見肌腱與骨結(jié)合緊密,無間隙,軟骨細(xì)胞排列規(guī)整,類似正常的腱骨界面結(jié)構(gòu)。對照組修復(fù)后4周可見疏松結(jié)締組織填充;修復(fù)后8周止點(diǎn)處可見大量成纖維細(xì)胞,少量膠原纖維連接,少量軟骨細(xì)胞形成;修復(fù)后12周可見膠原纖維連接,軟骨細(xì)胞排列紊亂;②生物力學(xué)測試:兩組最大負(fù)荷隨時間增加逐漸增大,實驗組修復(fù)后不同時間點(diǎn)的最大負(fù)荷高于對照組(P0.05);③結(jié)果表明:自體骨膜補(bǔ)片可有效促進(jìn)肩袖腱骨愈合。
[Abstract]:Background: new research has shown that rotator cuff patch can reduce tension between tendon and bone, provide attachment point for growth factor and cell growth, and promote biological reconstruction of cuff insertion point. However, there is no clear consensus as to which material is the safest and most effective material for rotator cuff patch. Objective: to investigate the effect of autologous periosteal patch on the healing of rotator cuff tendon. Methods: 48 New Zealand white rabbits were selected. An acute rotator cuff injury model was established and was randomly divided into two groups: the control group was repaired with simple suture and fixation, the experimental group was repaired with autogenous periosteum patch on the basis of the control group, and the proximal humerus specimens were collected at 812 weeks after repair. Results and conclusion: a large number of collagen fiber junctions and inflammatory cell infiltration were observed in the experimental group 4 weeks after repair, the proliferation of mesenchymal cells was obvious, and a small number of chondrocytes were observed. At 8 weeks after repair, the membrane internalized bone was seen, and a large number of new chondrocytes were found. At 12 weeks after repair, the tendon and bone were closely bound with the bone, and the chondrocytes were arranged regularly. In the control group, loose connective tissue filling was observed 4 weeks after repair, a large number of fibroblasts, a small number of collagen fibers and a few chondrocytes were observed at the end of 8 weeks after repair. 12 weeks after repair, collagen fiber junctions were observed. Biomechanical test showed that the maximum load of the two groups increased gradually with the increase of time. The maximum load at different time points after repair in the experimental group was higher than that in the control group (P 0.05). The results showed that the autogenous periosteum patch could effectively promote the healing of rotator cuff tendon.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院關(guān)節(jié)外科;承德醫(yī)學(xué)院附屬醫(yī)院病理科;
【分類號】：R318.08;R68

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