滑液营养条件下肌腱愈合的实验研究

为了探索单一滑液营养条件下肌腱的愈合能力，选用５０只新西兰大白兔，采用随机、单盲、自身对照实验设计。取动物前爪的屈趾深肌腱一段从中分切断，应用显微外科技术吻合后，置入该动物膝关节腔内。通过大体、扫描电镜、光镜、透射电镜观察及羟脯氨酸、氨基己糖测定，动态观察术后第１，２，３，４，６周实验样品吻合口及其附近细胞的形态、组织学改变以及胶原和基质代谢变化。结果发现，单一滑液营养条件下不仅能提供肌腱成活的全部营养，而且能满足肌腱愈合的需要。肌腱愈合由腱段本身的腱外膜细胞和腱内细胞共同完成。证明吻合后的肌腱在单一滑液营养条件下能够愈合。

EEXPERIMENTAL STUDY OF TENDON HEALING NOURISHED BY SYNOVIAL FLUID/

One of the most difficult problems on tendon surgery is adhesion formation during the process of tendon healing, which causes functional interference. This pathophysiologic pcocess is closely related to the ways of tendon nourishment and types of tendon healing. In order to understand whether the sutured tendon could heal without blood circulation, the process and types of tendon healing in the synovial fluid were studied by in vivo culture modle. Flexor digitorum profundus (FDP) segments from the front paw of 50 New Zedland white rabbits were cut in the middle and sutured with microsurgical technique, and then, preserved in the synovial cavitied of both knees of the rabbits. After 1, 2, 4, 6 weeks, the specimens from the synovial cavities were studied by gross observation, light microscope, scanning and transmission electron microscope, and biochemical determination. The results showed that the tendon which was nourished by synovial fluid not only could survive, but also could heal. Healing of the tendon was completed by activation and proliferation of both peritendon cells and cells in the tendon. The healing could be devided into 3 periods: malnutrition period (less than 1 week), reparative period (2 4 week) and rebuilding period (more than 4 week).