论文标题:低强度超声促进骨—股腱结合部位早期恢复的动物实验研究
The Animal Experimental Study on Low Intensity Pulsed Ultrasound for Early Restoration of Bone-Tendon Junction
论文作者 徐钢
论文导师 陈鸿辉,论文学位 硕士,论文专业 外科学
论文单位 暨南大学,点击次数 537,论文页数 62页File Size5927k
2005-04-01论文网 http://www.lw23.com/lunwen_161142/ 低强度超声;电刺激;骨-肌腱结合部位;功能锻炼
low-intensity pulsed ultrasound; surface functional electronic stimulation; bone-tendon junction; rehabilitation
研究目的:探讨低强度超声(LIPUS)对兔骨—肌腱结合部位愈合的影响,通过功能性电刺激(FES)诱导股四头肌收缩产生的早期功能锻炼,从而为术后的早期主动康复提供实验依据。 研究方法:72只成年雌性新西兰白兔(18周龄)随机分为对照组,超声组(LIPUS),和复合组(LIPUS+FES),建立兔部分髌骨切除模型。超声组在术后3天开始每日接受LIPUS刺激,复合组前4周给予LIPUS刺激,第5周改用FES诱导股四头肌收缩进行早期功能锻炼,所有刺激均于12周结束,对照组给予假刺激。术后6周、12周、18周处死动物取标本进行大体观察、组织学染色观察,同时进行生物力学检测评估骨—肌腱结合部位的恢复情况。 结果:组织学显示各组随时间推移而逐渐愈合。对照组表现为正常的愈合过程,即瘢痕组织形成并逐渐塑型。超声组和复合组在6周即出现了新生的骨质,超声组以细胞的增生和基质合成增多为主要特征,尤以早期明显。复合组细胞和胶原纤维排列更有规律,骨—肌腱结合部位重塑较快,两者的愈合优于对照组。生物力学结果也提示两组恢复较对照组迅速。但直至18周各组均仅见到近似于正常的纤维软骨带结构形成。 结论:低强度超声可以促进兔部分髌骨切除模型的骨—肌腱结合部位的早期恢复,在此基础上应用功能性电刺激诱导的股四头肌收缩进行早期功能锻炼有利于骨—肌腱结合部位的改造塑型。
Objective To explore the effects of low-intensity pulsed ultrasound (LIPUS) on bone-tendon junction in a Patella-Patellar Tendon Complex (PPTC) and early mobilization via surface functional electronic stimulation (FES) to establish an active postoperative rehabilitation program.Methods Animal model of partial patellectomy in 72 mature female New Zealand white rabbits (18-weeks-old) were established and randomly classified into 3 groups. The LIPUS and LIPUS+FES group was given low-intensity ultrasound exposure daily, At postoperative 5th week quadriceps muscles of the operated hindlimb will be stimulated via an FES, while the control group had sham exposure, quadriceps muscle-patella-patellar tendon (QMPPT) was harvest at 6、 12、 18weeks after operation for gross .. histological observation (standard H&E stain、 matrix proteoglycan and matrix collagen) and tensile strength of QMPPT complex examinations.Results The histological examination revealed that all of the groups wererestoration with healing over time. In the control group, the scar tissue progressively formed and remodeled between the tendon and bony cut ends. At 6 weeks, the outgrowth of new trabecular bone towards the tendon could be clearly observed in LIPUS and LIPUS+FES group. The characterizations of the microscopic appearance were hypercellular and increased synthesis of extracellular matrix in LIPUS group, especially in the earlier period, more regularity of the alignment of the cell and collagen fiber in LIPUS+FES group was found. The junction healing both of LIPUS and LIPUS+FES groups were better than control group. Mechanical testing result proved it too. But no a typical intermitted fibrocartilage between bone-tendon interface was seen in all of groups. The gross and histological observations showed that the tissue healing of ultrasound group was quicker than those of the control group.Conclusion low-intensity ultrasound could accelerate early healing of bone-tendon junction, on this base, early active rehabilitation by inducing tensile mechanical loading via FES on quadriceps muscles could affiliate bone-tendon junction remodel.
|
