中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (8): 1257-1261.doi: 10.3969/j.issn.2095-4344.2017.08.019

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

高频超声对肌腱损伤修复的评估:自身对照动物实验方案

刘  壮,李华光,张海峰,李晓丹,韩绍光   

  1. 四平市中心人民医院手足烧伤科,吉林省四平市  136000
  • 收稿日期:2016-12-14 出版日期:2017-03-18 发布日期:2017-04-14
  • 通讯作者: 刘壮,四平市中心人民医院手足烧伤科,吉林省四平市 136000
  • 作者简介:刘壮,男,1972年生,汉族,副主任医师,主要从事显微外科及皮肤软组织缺损修复的研究。
  • 基金资助:

    四平市科技发展计划项目

High-frequency ultrasound in the assessment of tendon injury and repair: study protocol for a self-controlled animal trial

Liu Zhuang, Li Hua-guang, Zhang Hai-feng, Li Xiao-dan, Han Shao-guang   

  1. Burn Department of Hand and Foot, Central People’s Hospital of Siping, Siping 136000, Jilin Province, China
  • Received:2016-12-14 Online:2017-03-18 Published:2017-04-14
  • Contact: Liu Zhuang, Burn Department of Hand and Foot, Central People’s Hospital of Siping, Siping 136000, Jilin Province, China
  • About author:Liu Zhuang, Associate chief physician, Burn Department of Hand and Foot, Central People’s Hospital of Siping, Siping 136000, Jilin Province, China
  • Supported by:

    the Science and Technology Development Program of Siping city

摘要:

文章快速阅读:

文题释义:

高频超声:指中心频率为10 MHz以上的超声,其成像具有极高的分辨力,最高可达20 μm。主要用于结构精密的小器官,如眼球;浅表器官,如皮肤、淋巴;腔内检查;浅表小血管血流多普勒扫描。
肌腱:是肌腹两端的索状或膜状致密结缔组织,便于肌肉附着和固定。一块肌肉的肌腱分附在两块或两块以上的不同骨上,是由于肌腱的牵引作用才能使肌肉的收缩带动不同骨的运动。
摘要
背景:
肌腱损伤是临床的常见疾病,外科吻合是治疗该疾病的常用手段。临床实践中,由于MRI检查费用昂贵及应用的限制,对于肌腱吻合后肌腱愈合情况的跟踪治疗长期靠临床医生的经验评估,一直缺乏便捷、准确的临床影像学支持。近些年,随着高频超声的改进和临床应用的增多,极大提高了闭合性肌腱损伤的诊断率,使得高频超声应用于肌腱损伤及修复后的评估成为临床研究的热点。
目的:采用高频超声与组织学检查相结合的方式,找到损伤肌腱修复过程中的超声影像学特点。
方法:研究为单中心、前瞻性、自身对照动物实验,将在中国四平市中心人民医院完成。实验选用SD大鼠130只,随机分为13组,每组10只。每只大鼠随机选一侧后足为手术肢,另一侧肢体为对照肢。对手术肢跟腱进行切断,第1组不予缝合,而第2-13组均按Kessler法吻合;第8-13组于外科吻合后第1天起,每日进行术肢肌腱屈伸活动数次的被动功能锻炼。于肌腱切断前和切断后(第1组),以及外科吻合后3,7,14,21,35,42 d分别对第2及8组、3及9组、4及10组、5及11组、6及12组、7及13组动物肌腱进行高频超声检查和苏木精-伊红染色。
结果与结论:实验的主要观察指标为高频超声观察的损伤肌腱修复、愈合情况;次要观察指标为苏木精-伊红染色检测的损伤肌腱组织病理学表现。实验结果将为高频超声应用于肌腱损伤、修复、愈合过程临床评估提供临床前数据,并为进一步开展促进肌腱功能恢复的康复程序提供依据。

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程
ORCID: 0000-0001-6421-3417(刘壮)

关键词: 组织构建, 组织工程, 动物实验, 肌腱损伤, 高频超声, 苏木精-伊红染色, 外科吻合, 缝合, 自身对照研究

Abstract:

BACKGROUND: Tendon injury is common in clinic, which is mainly treated by surgical anastomosis. Postoperative tendon healing is usually assessed through surgeons’ experience due to high cost and application restrictions of MRI examination. Thus there is still a lack of a convenient and objective imaging support. With the advancement and widespread application of high-frequency ultrasound, the diagnosis rate of tendon injury has been improved remarkably; thereafter, high-frequency ultrasound used for assessing tendon injury and repair
has become an issue of concern.
OBJECTIVE: To clarify the ultrasonic imaging features of tendon repair through high-frequency ultrasound scan combined with histological examination.
METHODS: This was a single-central, preoperative and self-controlled animal experiment and finished in the Central People’s Hospital of Siping, China. 130 adult male Highbrow chickens were selected and were then randomized into 13 groups (n=10 per group). One side of each chicken hind foot was randomly selected as experimental limb to undergo achillotomy followed by repair using the modified Kessler method (groups 2-13) or no treatment (group 1); the contralateral limb served as control. Moreover, passive flexion-extension functional training targeting the experimental limbs was performed in the groups 8-13 beginning at the 1st day after surgical anastomosis, several times a day. The high-frequency ultrasound and hematoxylin- eosin staining were conducted before and after chillotomy (group 1), and at 3 (groups 2 and 8), 7 (groups 3 and 9), 14 (groups 4 and 10), 21 (groups 5 and 11), 35 (groups 6 and 12) and 42 (groups 7 and 13) days after surgical anastomosis, respectively.
RESULTS AND CONCLUSION: The primary measurement outcomes were the repair and healing of the injured tendon as assessed by high-frequency ultrasound; the secondary outcomes were the pathological manifestations of the injured tendon detected by hematoxylin-eosin staining. Our findings will provide preclinical proof for high-frequency ultrasound use in the assessment of tendon injury, repair and healing as well as for the rehabilitation therapy that promotes function recovery in the future.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Animal Experimentation, Tenotomy, Surgical Procedures, Operative, Ultrasonography

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