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.doc

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
AnexperimentstudyofEGFcombinedwithdegradablecollagenmembranceinpreventionoftendonadhesioninchicken.Wangji-hongWenshu-zheng.Departmentofhandsurgery,InnermogerlionmedicalcollageNO2hospital,huhehaote,010030,china.
ObjectiveTostudytheadhesion-preventingeffectofepidermalgrowthfactor(EGF)combinedwithdegradablecollagenmembrane，anditseffectofimprovingtendonregenerationinside.MethodsThirtyten-montholdfowlwererandomlydividedintogroupsA,BandC(10eachgroup).Cutofftheflexortendoninthethirdtoethensutureit.IngroupA,suturedflexortendoninzoneⅡwereencapsulatedwithEGFcombinedwithdegradablecollagenmembrane;ingroupB,suturedflexortendonwereencapsulatedwithdegradablemembranealone;ingroupC,noEGFordegradablemembraneapplied.Fourweekslater,thespecimenswereevaluatedbymeansofmacroscopicobservation,vitodynamicstest,lightmicroscopeandelectronmicroscope.Results①IngroupofA,TherewerealargeamountofcollogenⅠinsidethesuturedtendon,theywerecloselyandandlineupinorder.Theamountofcollagen-fibronectinwaslessthanthatingroupsC(P<0.01)andtheadhesionobviouslywaslessthanthecontroltendons,TheperipheraltissueingroupAalmostremainsastheformallooseconnectivetissue,itwasintheadvancedstageoftendonregeneration.②IngroupA,therewerealargeamountofcollogenⅢinsidethesuturedtendon,theywerelooselyandwellorganized.TheperipheraltissueingroupBalmostremainsastheformallooseconnectivetissue,itwasintheearlierstageoftendonregeneration;=3\*GB3③IngroupC,adisorderoffiberwasfoundinthisgroup.Furthe