肌腱损伤后腱中心区域组织愈合能力

摘要

背景:实验发现,在肌腱损伤后,腱中心部分细胞生长增殖能力不如腱外膜细胞和周边部分腱内膜细胞,肌腱中心部位细胞的分裂增殖能力及自愈能力究竟如何?目的:研究肌腱损伤后腱中心区域组织的愈合能力.设计:设立对照的重复测量设计.地点和对象:南通医学院第二附属医院骨科.白色纯种Leghorn鸡8只,雌雄不拘,体质量约400 g,购自南通医学院动物中心,许可证号SYXK(苏)2002-0066.干预:在无菌条件下切取鸡双侧最长趾Ⅱ区趾深屈肌腱,切成4 nn长的肌腱段,分为两组,每组12条.实验组:切除腱外膜和外膜下腱组织肌的肌腱中心区域组织;对照组:仅剥除腱外膜组织的肌腱段.将两组肌腱组织进行体外培养,另取4条肌腱作正常对照组.主要观察指标:实验组和对照组于培养第9,8,7天取标本及正常对照组均进行大体观察和组织学检查.结果:腱细胞数两组培养前为167±13,培养第9,8,7天对照组分别为80±7,5±10,12±14,实验组分别为237±16,02±16,88±10.对照组均明显少于实验组及培养前,差异有显著性意义(P＜0.01);实验组比培养前明显增多,差异有显著性意义(P＜0.01);但培养第18和27天时,实验组腱细胞数较培养第9天少(P＜0.01).结论:屈肌腱损伤后肌腱中心区域组织有良好的愈合能力.%BACKGROUND: The experiments found that the cellular growth and proliferative ability in the central area of the tendon were poorer than those of epitenon cells and partial peripheral endotenon cells after tendon injury. However,how are the abilities of division and proliferation as well as the self-healing ability of the central ceils in the tendon?OBJECTIVE: To investigate the healing ability of the central area tissue in flexor tendons after injury.DESIGN: A controlled repeated measures design was performed.SETTING and PARTICIPANTS: The study was conducted in the Department of Orthopaedics,the Second Affiliated Hospital of Nantong Medical College. Eight white purebred Leghorn chicken in either gender with a body mass about 400 g(certification number: SYXK 2002-0066)were bought from Center for Experimental Animals,Nantong Medical University.INTERVENTIONS: Tendons of flexor digitorum profundus of the longest toes from 8 white Leghorn chickens were harvested in both sides of zone Ⅱ. Tissues were cut in 4-mm segments and divided into two groups with 12 segments 9ach. Study group: the central area tissue of flexor tendons without epitenon and tendon muscle under epitenon,and the control group: the tendon segments without epitenon. Specimens of two groups were cultured in vitro. Another 4 tendons were used as normal control group.MAIN OUTCOME MEASURES: Specimens were obtained from both groups and examined under optical microscope on the 9th,18th and 27th day after culture respectively for gross observation and histological tests.RESULTS: The number of tenocytes before culture in two groups was 167 ± 13. The numbers on the 9th,18th and 27th day of control group were 80±7,95 ± 10 and 112 ± 14 respectively and those of study group were 237 ± 16,202 ± 16,and 188 ± 10 respectively. The number of control group was significantly less than that of before culture and study group( P ＜ 0. 01) . The number of tenocytes was significantly increased in study group than that of before culture( P ＜ 0.01 ). The number of tenocytes of study group was more on the 9th day than that on the 18th and 27th day( P ＜ 0. 01 ).CONCLUSION: The central area tissue of flexor tendons has favorable healing ability after injury.