摘要
目的观察在兔膝关节滑膜切除术中置入壳聚糖膜以预防术后关节粘连的效果。方法将"#只新西兰白兔随机分为两组，壳聚糖膜组（实验组）和对照组。所有动物均行右侧膝关节滑膜切除术，术中实验组在滑膜切除区域放置壳聚糖膜，对照组不放膜。术毕$右下肢石膏管型固定%周。对每组动物行右膝关节的大体观察、半定量计分、组织学观察、生物力学分析及生物化学分析，所有的定量数据经&检验进行比较。结果半定量计分结果表明对照组的粘连程度较严重，差异有显著性意义（'(!)*)+）。光镜下组织学观察显示，对照组有大面积致密的厚纤维组织形成，实验组有松散的极薄的纤维组织形成。生物力学试验结果表明，实验组膝关节屈曲挛缩的角度小于对照组，差异有非常显著性意义（'(,)*)-）。生化分析结果表明，实验组粘连组织中的总胶原含量明显低于对照组，差异有非常显著性意义（'(!)*)-）；而实验组!型胶原所占的比例高于对照组，差异有显著性意义（'(!)*)+）。结论壳聚糖膜组关节粘连的程度明显低于对照组，壳聚糖膜可以有效预防膝关节术后粘连。
Objective To observe the results of preventing knee postoperative adhesions after synovectomy by chitosan membrane. Methods Thirty-two New Zealand white rabbits were randomly divided into two groups, the chitosan membrane experimental group and the control group. All animals underwent synovectomy of the right knee joint. Chitosan membrane was inserted in the suprapatellar pouch areas in the experimental group, whereas no film was inserted in the control group. After operation, the knee joints were immobilized with a plaster cast for 4 weeks. Rabbits in each group were assessed macroscopically, semiquantitatively, biomechanically and biochemically. All quantitative data were analysed by t test. Results Macroscopical finding: dense fibrous adhesion was observed in the control group, whereas little adhesion was found in experimental group. The former groups scores was higher than the later groups(P<0.05). Histological findings showed that dense fibrous tissue in the control group and loose fibrous tissue in the other group. The contractured angle of experimental group was significantly smaller than that of control group (P<0.01). The total collagen weight of adhesion tissue in experimental group was significantly less than that of control group(P<0.01). The percentage of type-Ⅲ collagen in the experimental group was higher than that of control group(P<0.05). Conclusion The results indicate that adhesion grades, strength and density in the chitosan membrane group were significantly less than those in control group. The chitosan membrane may effectively prevent postoperative joint adhesion.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第12期747-750,共4页
Chinese Journal of Orthopaedics
