蛋白酶腐蚀法在保留肌腱的血管铸型中的应用研究

目的　使用蛋白酶消化技术制作保留肌腱的血管铸型，拓展解剖学标本类型，丰富肌腱相关的临床解剖学研究方法。 方法　分别使用浓度为0.5%、1.0%、1.5%和2.0%的蛋白酶混合液对掌长肌进行分解实验，选出适合分解肌组织的基础浓度；以丙烯酸树脂为填充剂，灌注新鲜前臂标本的血管，制作铸型标本。填充剂凝固后，将前臂标本浸泡于起始浓度为1.0%的蛋白酶溶液，每24 h在混合液里加入35 g碱性蛋白酶粉，腐蚀5 d后获得保留肌腱的前臂血管铸型标本。 结果　通过对掌长肌组织进行分解实验发现，浓度为1.0%的蛋白酶混合液在肌腱断裂前能更充分地分解肌腹组织；通过对保留肌腱的血管铸型观察发现，其皮肤、脂肪组织和肌组织的肌腹基本消失，而骨骼、肌腱和铸型血管基本保存完好，可以清晰地观察皮肤及浅层、肌腱和肌腹丰富的血供来源、走向及其分布，清晰地观察铸型血管与皮肤及浅层、肌腱和肌腹的立体关系。 结论　以1.0%为起始浓度，每24 h加入1次起始浓度所需溶质（碱性蛋白酶）剂量的50%所配制的蛋白酶混合液，是制作保留肌腱的血管铸型的合适腐蚀液；保留肌腱的血管铸型为新的解剖学标本类型，并丰富了肌腱相关的临床解剖学研究方法。

The applied study of protease etching in vascular casting of the retained tendon

Objective　To enrich the clinical anatomical research methods related to tendon by using protease digestion technique to make vascular casting of retained tendon.　Methods　0.5%, 1.0%, 1.5% and 2.0% concentrations of protease mixture were used respectively to decompose palmaris longus muscle and the suitable basic concentration was selected. The forearm vascular casting specimens were filled with acrylic resin and perfused to make casting specimen. After the filler was coagulated, the forearm vascular casting specimens were soaked into the protease solution mixture with the 1.0 % initial concentration and then during the soaking period, 35 g of alkaline protease powder was added to the mixture every 24 h, after 5 days corrosion, the forearm vessel casting of the retained tendon was made. Results　Through the decomposition of the palmar longus muscle tissue，we found that the protease solution mixture with a 1.0 % concentration could decompose adequately muscle tissue before the tendon fractured. We found that the skin, adipose tissue and muscle tissue basically disappeared. Bones, tendons and cast blood vessels well preserved, the skin, the source and distribution of blood supply in the superficial layer, tendon and muscle, the relationship between cast blood vessels and skin, superficial layer, tendon and muscle can be clearly observed.　Conclusions　Using 1.0 % protease mixture as the starting concentration and adding protease mixture with 50% of the alkaline protease powder every 24 h is an appropriate corrosion method for making the vascular casting of the retained tendon. The vascular casting of retained tendons is a new type of anatomical skill, can enrich the clinical anatomical research methods related to tendon.