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兔屈肌腱手术后预防腱周粘连形成:局部使用干扰素-α、干扰素-β和5-氟尿嘧啶的比较研究

Prevention of Peritendinous Adhesion Formation After the Flexor Tendon Surgery in Rabbits: A Comparative Study Between Use of Local Interferon-α, Interferon-β, and 5-Fluorouracil.

作者信息

Fatemi Mohammad Javad, Shirani Shahram, Sobhani Roohollah, Lebaschi Amir Hossein, Gharegozlou Mohammad Javad, Bagheri Tooran, Pedram Mirsepehr, Saberi Mohsen, Araghi Shirin, Fatemi Mohammad Ali

出版信息

Ann Plast Surg. 2018 Feb;80(2):171-175. doi: 10.1097/SAP.0000000000001169.

Abstract

BACKGROUND

Peritendinous adhesion is the most common complication after tendon surgery, particularly in zone II of the hand. Prevention of inflammation around the tendon, which develops after trauma and surgery, can decrease the tendon adhesion formation. This study compares the effect of some anti-inflammatory cytokines with 5-fluorouracil (5-FU) on the tensile strength and in prevention of peritendinous adhesion formation.

METHODS

Sixteen rabbits were allocated equally into 4 groups. Tendons of the index and ring fingers in zone II of the right hind paw were cut in all animals and then repaired. Interferon (IFN)-α in group 1, 5-FU in group 2, normal saline in group 3, and IFN-β in group 4 were locally applied to the repaired sites. Three weeks later, tensometric and histopathologic evaluations were performed.

RESULTS

The force required for removing the tendon from the sheath was not different between the groups (P = 0.130), but the time required for removal was significantly shorter in 5-FU group (P = 0.049). The strength of repair was not different between the groups in terms of force and time needed for rupture (P = 0.11 and 0.67, respectively). In histopathologic examination, normal architecture of the tendon and peritendon environment was less disturbed in the IFN groups, especially in IFN-β specimens.

CONCLUSIONS

Local application of 5-FU significantly reduced peritendinous adhesion. Local IFN-α and IFN-β had no significant effect on the prevention of peritendinous adhesion formation. The strength of the repair was not affected by these cytokines and 5-FU.

摘要

背景

腱周粘连是肌腱手术后最常见的并发症,尤其是在手的Ⅱ区。预防创伤和手术后肌腱周围发生的炎症可减少肌腱粘连的形成。本研究比较了某些抗炎细胞因子与5-氟尿嘧啶(5-FU)对拉伸强度及预防腱周粘连形成的作用。

方法

16只兔子被平均分为4组。所有动物右后爪Ⅱ区的示指和环指指肌腱均被切断,然后进行修复。第1组局部应用干扰素(IFN)-α,第2组局部应用5-FU,第3组局部应用生理盐水,第4组局部应用IFN-β于修复部位。3周后,进行张力测定和组织病理学评估。

结果

各组间从腱鞘中取出肌腱所需的力量无差异(P = 0.130),但5-FU组取出所需时间显著更短(P = 0.049)。各组间修复强度在断裂所需力量和时间方面无差异(分别为P = 0.11和0.67)。在组织病理学检查中,IFN组尤其是IFN-β标本中,肌腱和腱周环境的正常结构受干扰较小。

结论

局部应用5-FU可显著减少腱周粘连。局部应用IFN-α和IFN-β对预防腱周粘连形成无显著作用。这些细胞因子和5-FU不影响修复强度。

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