解剖学报 ›› 2022, Vol. 53 ›› Issue (4): 520-525.doi: 10.16098/j.issn.0529-1356.2022.04.016

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开放手术与微创手术建立膝前交叉韧带本体感觉减退模型对比

张磊1* 奉琦2 王萍2 程翰文2 熊鹿静2
  

  1. 1. 西南医科大学附属中医医院骨伤科, 四川 泸州 646600; 2. 西南医科大学临床医学院,四川 泸州 646600
  • 收稿日期:2020-12-07 修回日期:2021-02-08 出版日期:2022-08-06 发布日期:2022-09-11
  • 通讯作者: 张磊 E-mail:307501597@qq.com
  • 基金资助:
    2018年泸州市人民政府-西南医科大学科技战略合作;2019年西南医科大学附属中医医院科研项目;2020年国家自然科学基金课题

Comparison on the establishment of proprioceptive hypoesthesia model of anterior cruciate ligament by open surgery and minimally invasive surgery

ZHANG  Lei1* FENG  Qi2  WANG  Ping2 CHENG  Han-wen XIONG  Lu-jing2   

  1. 1. Department of Orthopedics and Traumatology, Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646600,China; 2. Clinical Medical College of Southwest Medical University,Sichuan Luzhou 646600,China
  • Received:2020-12-07 Revised:2021-02-08 Online:2022-08-06 Published:2022-09-11
  • Contact: ZHANG Lei E-mail:307501597@qq.com

摘要:

目的  对比开放手术与微创手术在建立膝前交叉韧带(ACL)本体感觉减退模型时的差异,为基础研究提供一个优化的动物模型。  方法  30只正常食蟹猴被随机分为5组,微创手术组:关节镜下进行单侧ACL损伤,n=6;开放手术组:直接切开膝关节进行单侧ACL损伤,n=6;微创假手术组:仅进行膝关节镜检清理不损伤单侧ACL,n=6;开放假手术组:直接切开膝关节仅作单侧ACL探查而不损伤单侧ACL,n=6;正常组:不作任何手术干预,n=6。4周后进行神经电生理检查[体感诱发电位(SEPs)与运动神经传导速度(MCV)],再将食蟹猴处死并取其单侧ACL进行氯化金染色,观察和记录ACL本体感受器的变异数和数量。   结果  在神经电生理方面,除正常组以外的其余4组SEPs和MCV潜伏期均有延长,波幅均有下降。在本体感受器方面,微创手术组总数:578.00±12.68,波幅:36.33±3.72;开放手术组总数:367.67±9.33,波幅:77.00±5.55;开放假手术组总数:969.00±18.26,波幅:0±0;正常组总数:970.46±16.34,波幅:0±0;除正常组以外的其余4组本体感受器总数均有下降,变异数均上升在两方面的对比中,开放手术组与微创手术组,开放手术组与开放假手术组对比,微创手术组与微创假手术组对比,差异均有显著性(P<0.05)。开放假手术组与微创假手术组相比,以及两组分别与正常组相比,差异均无显著性(P > 0.05)。   结论  开放手术组和微创手术组均可建造ACL本体感觉减退模型,但微创手术对ACL周围组织的损伤更小,更能保证模型的科学性、单一性,减少了实验误差,在ACL损伤的基础研究中具有重要意义。

关键词: 前交叉韧带损伤, 膝关节镜, 本体感觉, 神经电生理, 食蟹猴

Abstract:

Objective  To provide an optimized animal model for basic research by comparing the establishment of proprioceptive hypoesthesia model of anterior cruciate ligament (ACL) by open surgery and minimally invasive surgery.    Methods  Totally 30 normal cynomolgus monkeys were randomly divided into five groups: minimally invasive surgery group: unilateral ACL injury under arthroscope, n=6; open surgery group: unilateral ACL injury through direct incision of knee joint, n=6; minimally invasive sham operation group: unilateral ACL without injury through arthroscopic cleaning only, n=6; open surgery group: unilateral ACL exploration without injury through direct incision of knee joint, n=6; positive normal group: no surgical intervention, n=6. Four weeks later, the neurophysiological examination [somatosensory evoked potentials (SEPs) and motor nerve conduction velocity (MCV) ] was carried out. The macaque was killed and its unilateral ACL was stained with gold chloride. The number and variation of ACL proprioceptors were observed and recorded.    Results  In the aspect of neuroelectrophysiology, except the normal group, the latency of SEPs and MCV were prolonged, and the amplitude decreased. In terms of proprioceptors, the total number of minimally invasive surgery group: 578.00±12.68, amplitude: 36.33±3.72; total number of open surgery group: 367.67±9.33, amplitude: 77.00±5.55; total number of open sham operation group: 969.00±18.26, amplitude: 0±0; total number of normal group: 970.46±16.34, amplitude: 0±0, the total number of proprioceptors decreased and the number of variation increased in all four groups except the normal group. At the same time, in the comparison of the two aspects, there were significant differences between the open operation group and the minimally invasive operation group, the open operation group and the open sham operation group, and the minimally invasive operation group and the minimally invasive sham operation group (P<0.05). There were no significant difference between the open sham operation group and the minimally invasive sham operation group, and between the two groups and the normal group, respectively (P>0.05).     Conclusion  Both the open operation group and the minimally invasive operation group can build ACL proprioceptive hypoesthesia model, but the minimally invasive operation has less damage to the tissues around ACL, more scientific and single model, and less experimental error, which is of great significance in the basic research of ACL injury.

Key words: Anterior cruciate ligament injury, Knee arthroscopy, Proprioception, Electrophysiology, Cynomolgus monkey

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