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时间:2018-12-07
《临床医学毕业论文experimentalresearch肩袖撕裂病人肩峰下滑囊顶部的组织学变化》由会员上传分享,免费在线阅读,更多相关内容在学术论文-天天文库。
1、ExperimentalResearch肩袖撕裂病人肩峰下滑囊顶部的组织学变化姓名:2014年6月25日ExperimentalResearch肩袖撕裂病人肩峰下滑囊顶部的组织学变化作者:朱锦宇,S宏升,朱庆生,桥本卓,信原克哉【摘要】[目的]观察肩袖撕裂病人肩峰K滑囊(subacromialbursa,SAB)顶部的组织学变化。[方法]在肩袖撕裂病人修复手术中,分别取撕裂处和远离撕裂处SAB顶部,采用组织学、免疫组织化学和电镜观察上述两处SAB的形态学变化,通过计算机图像分析系统对SAB切片的细胞数量进行定量评价,并与正常SAB比较。[结果
2、]实验组所有肩袖撕裂病人SAB顶部,不管是取自撕裂部位还是远隔部位,均可见细胞数量和血管分布的培加,细胞数量显著高于正常SAB(P0.05),且均未观察到炎性细胞浸润。肩袖撕裂的不同类型、SAB的不冋增厚程度以及SAB是否积液,SAB细胞数量无显著性差异。超微结构可见到以B型细胞为主,细胞狭长。免疫组织化学染色也证实肩袖撕裂病人SAB顶部主要系B型滑膜细胞。[结论]肩袖撕裂病人SAB顶部的细胞数量的增加是一种反应性的增加,而不是真正的炎症,而丑这种反应是广泛性的。SAB的变化系肩袖撕裂引起的继发反应。【关键词】肩关节;滑囊;肩袖Abstrac
3、t:[Objective]Toinvestigatethemorphologicalchangesoftheroofofthesubacromialbursaandtheextentofinvolvementofthesubacromialbursaafterrotatorcufftear.[Method]Fortheexperimentalgroup,theroofofthesubacromialbursawasobtainedfrompatientswithrotatorcufftearbothatthetearsiteand2.5to3
4、.0cmdistaltothetearsiteduringsurgeryofrotatorcuffrepair.Forthecontrolgroup,theroofofthesubacromialbursawasobtainedduringsurgeryofrecurrentshoulderdislocationorhumeralshaftfractureattheexposuresite.Thespecimenswereprocessedforhistologicalstaining,immunohistochemicalanalysisa
5、ndfortransmissionelectronmicroscopy.Thenumberofcellswerequantitatedbycountingcellswithblue-stainednucleusinthesubacromialbursausingacomputerimageanalysissystem.[Result]Thenumberofcellsincreasedsignificantlyintheroofofthesubacromialbursaobtainedfrombothsites,thetearsiteandth
6、edistalsite,inthepatientswithrotatorcufftear,comparedwiththenormalbursa(P0.05byANOVA).However,therewasnodifferenceinthebursalreactionamongtherotatorcuffteartype,thebursathicknessandthepresenceoffluidinthebursa.ThegreatmajorityofcellsweretypeBcellsobservedundertransmissionel
7、ectronmicroscopyandconfirmedbyimmunohistochemicalanalysis.[Conclusion]Theincreaseincellularityintheroofofthesubacromialbursaofpatientswithrotatorcufftearisareactionratherthananinflammatoryprocessandtheinvolvementofthesubacromialbursaisnotlimitedinextent.Thereactionoftheroof
8、ofthesubacromialbursaissecondarytotherotatorcufftearratherthanprimarycauseoftherot
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