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1、表皮生长因子复合可降解胶原膜防止鸡鞘管区肌腱粘连的实验研究王继宏温树正（内蒙古医学院第二附属医院手外二科内蒙古呼和浩特010030）[摘要]目的观察和探索表皮生长因子复合胶原膜在预防鞘管区肌腱粘连、促进肌腱内源性愈合中的作用。方法将30只10月龄雄性leghorn鸡随机分为A、B、C组，每组10只。将每只鸡的左足第三趾造成挤压撕脱伤模型，用改良Kessler缝合法缝接。A组:断端包裹复合有EGF的胶原膜；B组:断端只包裹单纯的胶原膜；C组:断端不加任何处理。术后4周,对标本进行肉眼观察、生物力学测试、光镜、电
2、镜等观察。结果A组肌腱粘连程度较轻，腱缝合段内的胶原纤维数量多,以粗大的Ⅰ型胶原为主；成纤维细胞数量少，腱细胞成熟。B组肌腱粘连较轻，但腱缝合段内的胶原纤维数量少,排列稀疏，以纤细的Ⅲ型胶原为主；C组肌腱与周围组织粘连重，腱缝合段内的胶原纤维数量较多,排列紊乱，Ⅰ、Ⅲ型胶原交错排列。结论1、可降解胶原膜能起到屏障肌腱外源性愈合、防止肌腱粘连的作用，但同时也明显减慢了肌腱的愈合速度。2、EGF复合可降解胶原膜,既能起到屏障肌腱外源性愈合、防止肌腱粘连的作用，同时EGF也加快了肌腱的内源性愈合速度，起到了较理想的
3、防止粘连的效果。【关键词】表皮生长因子胶原膜肌腱粘连实验研究AnexperimentstudyofEGFcombinedwithdegradablecollagenmembranceinpreventionoftendonadhesioninchicken.Wangji-hongWenshu-zheng.Departmentofhandsurgery,InnermogerlionmedicalcollageNO2hospital,huhehaote,010030,china.ObjectiveTostudyt
4、headhesion-preventingeffectofepidermalgrowthfactor(EGF)combinedwithdegradablecollagenmembrane，anditseffectofimprovingtendonregenerationinside.Methods Thirtyten-montholdfowlwererandomlydividedintogroupsA,BandC(10eachgroup).Cutofftheflexortendoninthethirdtoet
5、hensutureit.IngroupA,suturedflexortendoninzoneⅡwereencapsulatedwithEGFcombinedwithdegradablecollagenmembrane;ingroupB,suturedflexortendonwereencapsulatedwithdegradablemembranealone;ingroupC,noEGFordegradablemembraneapplied.Fourweekslater,the9specimenswereev
6、aluatedbymeansofmacroscopicobservation,vitodynamicstest,lightmicroscopeandelectronmicroscope.Results①IngroupofA,TherewerealargeamountofcollogenⅠinsidethesuturedtendon,theywerecloselyandandlineupinorder.Theamountofcollagen-fibronectinwaslessthanthatingroupsC
7、(P<0.01)andtheadhesionobviouslywaslessthanthecontroltendons,TheperipheraltissueingroupAalmostremainsastheformallooseconnectivetissue,itwasintheadvancedstageoftendonregeneration.②IngroupA,therewerealargeamountofcollogenⅢinsidethesuturedtendon,theywereloosely
8、andwellorganized.TheperipheraltissueingroupBalmostremainsastheformallooseconnectivetissue,itwasintheearlierstageoftendonregeneration;③IngroupC,adisorderoffiberwasfoundinthisgroup.Furthermore,theperiphe
