深筋膜包裹肌腱防止粘连的实验研究

目的 为探索防止肌腱粘连的方法，采用深筋膜包裹、应用bFGF及早期锻炼等方法并进行动物实验以提供对临床有用的参考依据。方法 选SD大白鼠16只（32条跟腱）分成A、B、C、D四组。A组跟腱缝合后用深筋膜包裹并加bFGF;B组跟腱缝合后用深筋膜包裹；C组为跟腿缝合加bFGF;D组为跟腱单纯缝合。术后3天行控制性主被动活动，3周后处死，并观察和测量各组粘连性状和粘连面积及切片观察。结果 A组与B组跟腱与周围组织粘连面积小，粘连程度轻；而C组与D组粘连面积大，粘连程度深。跟腱断裂缝合后用深筋膜包裹组与跟腱断裂单纯缝合组的粘连面积在统计学上有显性差异（P＜0．05）。切片可见C、D组腱旁组织较多，尤以C组为重；而A、B组腱旁组织少，腱细胞核较多，尤以A组腱细胞核多。结论 本研究提示：肌腱缝合术后应用深筋膜包裹断端可防止肌腱粘连。

Experimental research of repairing tendon encapsulated by deep fascia to prevent adhesion of tendon

Objective To purpose the research to prevent the adhesion of tendon,which used deep fascia evaluating tendons and bFGF,primary exercise in an imal ex periment .Methods Sixteen white mouse(total thirty-two achilles tendons)were di -vid ed into A,B,C,D.four groups.Group A:achilles tendon were encapsulated by deep fascia add bFGF,Group B:achilles ten-don were encapsulated by deep fascia.Group C:achilles tendon added bFGF.Group D:only Achilles ten don was re paired.After three days,rehabilitation training were conducted.Three weeks later extent of ad hesion were evaluated.Results In groups C and D extent of adhesion were larger than that of in groups A and B.There were sig nificant dif ferences(P<0.05).On the section there are too much more tissue beside tendon in group C and D than groups A and B,but less ten-don cell than groups A and B.Conclusion This experiment demonstrated that en capsulatingd tendon by deep fascia can pre-vent adhesion of tendon.