同种异体腱移植重建膝关节交叉韧带探究.docVIP

同种异体腱移植重建膝关节交叉韧带探究 　 作者：赵永生，滕学仁，胡光亮，周伦 【摘要】 目的 从实验角度观察程序冷冻液氮保存和－80℃深低温保存方法处理同种异体髌腱后重建膝关节交叉韧带的愈合过程并比较其差异。方法 将兔的1/2骨髌腱骨复合体经-80℃深低温保存和程序冷冻液氮保存2周后观察冻存变化差异并行同种异体移植重建前交叉韧带，分别于术后3周和8周观察细胞毒反应、细胞活性、最大载荷和形态学变化等指标进行比较并与自体移植组对照。结果 a)经程序冷冻液氮保存方法处理后，髌腱的最大载荷无明显下降，细胞活性得到了较好的保存，组织学观察冷冻损伤较－80℃深低温保存方法轻微；b)程序冷冻液氮保存处理的移植物在术后未表现明显的排斥反应，且免疫反应随时间的推移而下降；c)移植后3周，各组移植物的最大载荷无显著差异(P＞0.05)，移植后8周，程序冷冻液氮保存组移植物的最大载荷(55.87±1.86)N优于－80℃深低温保存组(52.14±2.79)，而和自体移植组相近(57.70±2.76)N；d)从组织学观察看，－80℃深低温保存组和程序冷冻液氮保存组移植后的愈合过程均和自体移植组相似，而程序冷冻液氮保存组的愈合过程和组织学行为更接近于自体移植组。结论 经深低温保存的兔异体髌腱重建膝关节交叉韧带后愈合过程和自体韧带移植重建过程相似。程序冷冻液氮保存法优于传统的－80℃深低温保存法。 【关键词】 同种异体腱；交叉韧带；重建 Abstract：Objective To study the difference of healing process of reconstructing the knee cruciate ligaments with allograft tendons which were treated by program freezing and －80℃ deepfrozen.Methods Reconstruct the ACL of the knee with the BPTB of rabbits which had been preserved for 2 weeks with －80℃ deepfrozen or liquid nitrogen deepfrozen after program freezing，and the cells poison response，cells activity，the maximum load and morphologic changes of the grafts were observed to compare the two allografting groups each other and compare them with the autografting group.Results 1.After treated by：program freezing，the maximum load of the allografts has no evident decrease and the cell activity of allografts was preserved well，the frozen hurt after program freezing was more slight than －80℃ deepfrozen，2.No evident reject reaction can be seen during the healing process after deep frozen and the reject reaction declined as the time pass by.3.Three weeks afer the allografting，there was no significant difference between the two al lografting groups in maximum load(P＞0.05)，Eight weeks later，the maximum load of the　group that was preserved by liquid nitrogen after program freezing(76.60±4.67)N was better than the group that was preserved by －80℃ deepfrozen(75.99±4.20) and similar with the autografting group(76.72±2.55).4.The healing process and histological behavi