本文選題：肌腱 + 縫合��； 參考：《吉林大學(xué)》2015年碩士論文

【摘要】：研究背景和目的 肌腱縫合方法一般分為中心縫合和周邊縫合兩種，現(xiàn)認(rèn)為中心縫合聯(lián)合周邊縫合是行之有效的肌腱修復(fù)方式，而兩種方式的先后縫合順序所提供的強(qiáng)度是否有差異，國(guó)內(nèi)外報(bào)道甚少。現(xiàn)采用體外模擬實(shí)驗(yàn)進(jìn)行中心縫合和周邊縫合順序強(qiáng)度差異的生物力學(xué)研究，明確在同等條件及縫合方法時(shí)可提供更大抗張強(qiáng)度的縫合方式順序，減少術(shù)后肌腱斷裂的發(fā)生，有利于術(shù)后的早期主動(dòng)功能鍛煉，為臨床屈肌腱修復(fù)提供理論依據(jù)。 材料和方法 將48只新鮮成年豬前蹄第2趾趾深屈肌腱造成切割傷，每個(gè)樣本均采用中心縫合與周邊縫合2種縫合方式，中心縫合選用改良Kessler法和Cruciate法，周邊縫合選用Running法和Cross-stitch法，交叉組合成4組，每組按先中心縫合和先周邊縫合分為2小組，每小組6個(gè)樣本。記錄縫合時(shí)間，術(shù)后即刻應(yīng)用力學(xué)測(cè)定儀測(cè)定修復(fù)肌腱的2mm間隙力，最大負(fù)荷，，根據(jù)位移-負(fù)荷曲線計(jì)算剛度，并行統(tǒng)計(jì)學(xué)分析。 結(jié)果 改良Kessler+Running組、改良Kessler+Cross-stitch組和Cruciate+Cross-stitch組中先周邊縫合組的2mm間隙力明顯高于先中心縫合組（P＜0.05）。周邊縫合選用Cross-stitch法時(shí)先周邊縫合組最大負(fù)荷高于先中心縫合組，而在周邊縫合選用Running法時(shí)最大負(fù)荷無(wú)顯著性差異。無(wú)論選擇何種周邊縫合時(shí)2mm間隙力及最大負(fù)荷皆為Cruciate法大于改良Kessler法。先中心縫合組與先周邊縫合組剛度相近。先周邊縫合耗時(shí)較先中心縫合增加5%～15%。 結(jié)論 1.在相同條件及縫合方法修復(fù)屈肌腱時(shí)選擇先周邊縫合可比先中心縫合提供更大的抗張強(qiáng)度，為修復(fù)肌腱的早期功能鍛煉提供更安全的強(qiáng)度保障。2.肌腱縫合后強(qiáng)度與通過(guò)吻合口縫線股數(shù)正相關(guān)，在肌腱修復(fù)的方法中，盡量采用四股以上的中心縫合方法。
[Abstract]:Background and purpose of the study Tendon suture is generally divided into central suture and peripheral suture. It is considered that central suture combined with peripheral suture is an effective method of tendon repair. There are very few reports at home and abroad. In this paper, the biomechanical study on the strength difference between central suture and peripheral suture sequence was carried out by using in vitro simulation experiment. It is clear that the suture mode sequence with greater tensile strength can be provided under the same condition and suture method, and the occurrence of tendon rupture after operation can be reduced. It is beneficial to early active exercise after operation and provides theoretical basis for clinical flexor tendon repair. Materials and methods 48 fresh adult pigs were incised from the second toe deep flexor tendon of the second toe. Each sample was sutured by central suture and peripheral suture. The central suture was performed by modified Kessler and Cruciate, and the peripheral suture by Running and Cross-stitch. Each group was divided into 2 groups according to central suture and peripheral suture. The time of suture was recorded and the 2mm gap force and maximum load were measured by mechanical analyzer immediately after operation. The stiffness was calculated according to the displacement-load curve and the statistical analysis was carried out. Result In modified Kessler Running group, modified Kessler Cross-stitch group and Cruciate Cross-stitch group, the interspace force of 2mm in the first peripheral suture group was significantly higher than that in the central suture group (P < 0.05). The maximum load of peripheral suture group was higher than that of central suture group when peripheral suture was used Cross-stitch method, but the maximum load of peripheral suture group with Running method had no significant difference. No matter what peripheral suture was selected, the gap force and maximum load of 2mm were greater by Cruciate than by modified Kessler. The stiffness of the central suture group was similar to that of the peripheral suture group. Peripheral suture takes 5 times longer than central suture. Conclusion 1. When repairing flexor tendon under the same condition and suture method, the peripheral suture was better than central suture to provide greater tensile strength, which provided a safer strength guarantee for early functional exercise of tendon repair. The strength of tendon suture was positively correlated with the number of sutures through the anastomosis. In the method of tendon repair, more than four strands of central suture were used as far as possible.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R687.2

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