本文選題：跟腱斷裂 + 微創(chuàng)��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]設(shè)計及制作急性跟腱斷裂微創(chuàng)縫合器械;制作跟腱斷裂動物模型;通過生物力學(xué)試驗對比研究微創(chuàng)縫合法、Kessler法和Krackow法的失效載荷;旨在為急性跟腱斷裂提供更有效的臨床解決辦法。[方法]設(shè)計及制作跟腱斷裂微創(chuàng)縫合器械。對人體跟腱和豬趾深屈肌腱進(jìn)行解剖和測量,以豬趾深屈肌腱代替人體跟腱進(jìn)行試驗。溫室下選新鮮豬小腿標(biāo)本(自膝關(guān)節(jié)以下離斷)34只,10只用于解剖觀察及測量。24只標(biāo)本解剖暴露趾深屈肌腱,模擬跟腱斷裂,將豬趾深屈肌腱橫行銳性離斷,切口與腱纖維走形垂直,并將斷端延冠狀位、矢狀位各劈裂3刀,間隔1mm,深度10mm,形成馬尾狀,建立跟腱斷裂模型,然后隨機(jī)分為3組(A、B、C),每組8條肌腱,分別采用自制器械微創(chuàng)縫合器法(A組)、Kessler縫合法(B組)和Krackow縫合法(C組),縫合完畢置于-10℃冰箱中備用。拉力測試前常溫解凍標(biāo)本,后將標(biāo)本置于日本島津AG—150KN材料拉力試驗機(jī)的加載盤中,均勻拉伸至縫合失敗,記錄縫合失效時的最大載荷等,采集的數(shù)據(jù)經(jīng)spss15.0系統(tǒng)軟件進(jìn)行處理并得出實(shí)驗結(jié)果。[結(jié)果]人體跟腱平均長度(155.2±5.3)mm,距止點(diǎn)5cm處平均寬度(12.2±0.9)mm,厚度(6.1±0.3)mm。豬趾深屈肌腱測量平均長度(128.5±10.3)mm,距止點(diǎn) 5cm 處平均寬度(11.8±0.8)mm,厚度(5.2土0.5)mm。�？商娲梭w跟腱進(jìn)行試驗。微創(chuàng)縫合法、Kessler法、Krackow法三組失效載荷平均為(193.8±36.7)(159.3±5.7)(211±28.5)N,對三組試驗最大載荷進(jìn)行兩兩比較的LSD-t檢驗,微創(chuàng)縫合組和Krackow組之間差異無統(tǒng)計學(xué)意義,微創(chuàng)縫合組和Kessler組、Kessler組和Krackow組之間有統(tǒng)計學(xué)意義。[結(jié)論]豬趾深屈肌腱可替代人體跟腱進(jìn)行生物力學(xué)試驗,新型微創(chuàng)縫合法優(yōu)于Kessler縫合法,三種方法中,Kessler法提供的失效載荷最小,新型微創(chuàng)縫合法和Krakow之間無統(tǒng)計學(xué)差異。生物力學(xué)試驗證實(shí)新型微創(chuàng)縫合法較傳統(tǒng)固定方法操作簡單,可達(dá)到傳統(tǒng)縫合方法的縫合效果。新型微創(chuàng)縫合牢靠,使用簡便、微創(chuàng),并發(fā)癥少。
[Abstract]:[objective] to design and make minimally invasive suture apparatus for acute rupture of Achilles tendon, to make animal model of rupture of Achilles tendon, to compare the failure load of minimally invasive suture method with Kessler method and Krackow method by biomechanical test. To provide a more effective clinical solution for acute Achilles tendon rupture. [methods] A minimally invasive suture apparatus for rupture of Achilles tendon was designed and manufactured. The human Achilles tendon and porcine deep flexor digitorum tendon were dissected and measured, and the human Achilles tendon was replaced by the pig deep flexor digitorum tendon. Under the greenhouse, 34 fresh pig calf specimens (dissected from the knee joint) were selected for anatomical observation and measurement. 24 specimens were dissected to expose the deep flexor digitorum tendon, to simulate the rupture of the Achilles tendon, and to transect the tendon of the deep flexor digitorum muscle strikingly. The incision was perpendicular to the shape of tendon fibers, and was divided into three groups in coronal position and sagittal position, with 1 mm interval and 10 mm depth, to form a cauda equina model and to establish a rupture model of Achilles tendon. Then it was randomly divided into 3 groups (Agnor BUC), with 8 tendons in each group. Kessler's suture (group B) and Krackow's suture (group C) were used in group A and group C respectively. After suture, the suture was placed in refrigerator at -10 鈩，

本文編號：2096308