【摘要】 目的通过对海水浸泡犬离断肢体再植修复术后的肌腱超声观察,记录其声像学特征,利用超声对其修复程度进行检测,评价显微外科技术进行修复与重建的可能性。方法犬肌腱损伤修复术后8、16周进行超声检查,健康杂种家犬24只,每只犬左(或右)小腿均以于术造成不全离断及大部分离断。伤后分别将犬伤肢浸泡在自然的大海中各1、2、3 h。用L12-5和L17-5探头,于术后8、1 6周对海水浸泡时犬肌腱(胫前肌腱)损伤修复后的改变进行观察。结果 3只实验犬死亡,1只犬因钢板外露未能探查,其余的实验犬肌腱缝合处超声显示,伤组、断组以及浸泡1、2、3 h的实验犬,超声扫查的胫前肌腱数据无显著性差异,故合并组别按术后8、16周总结经验。术后8周,粘连3只(含1只癜痕连接),其余的实验犬肌腱均获得较好的愈合;术后16周,死亡2只,粘连3只,其余的实验犬肌腱回声几乎同健侧。结论通过对海水浸泡犬离断肢体再植修复术后的肌腱超声观察,海战时在舰船上对肌腱实施显微外科的手术是可行的,超声能观察肌腱的整个愈合过程,对其愈合情况进行超声动态随访。更多还原

【Abstract】 Objective In an experimental limb replantation,the amputated limb had been soaked in sea water for various length of time and the limbs were replanted with microsurgical technique.The repaired tendon were examined with ultasonography to observe manner of repair and growth of the tendons to evaluate the feasibility of emergency replantation on hospital ship.Methods Of 24 mongreal dogs one hind limb was complete or incomplete amputatied.and kept in sea water for 1,2 or 3 hours.Replantation was proceeded as routine procedure,i.e.internal fixation of bone with plate and screw or intramedullary pins,suturing of nerves with microsurgical suture,suturing Extensor pollicis longus,extensor digitorum communis and Tibialis anticus with Kessler’s suture.Ultrasonographic examination with L12-5,L17-5 detectors were made at 8th and 16th postoperative weeks.Results Three dogs died of complications of lung.One dog was discharged for exposure of plate and screw.No difference in tendon healing can be found between 1,2 and 3 hour sea water soaking groups.In 8 weeks examination,adhesion was found in 3 legs and in one of the three legs,the tendon was connected by scar healing,while in the rest legs,the tendons healed well.In 16 weeks examination, 2 dogs died and 3 limbs had tendon adhesion.The tendons of all the other replanted limbs were healed soundly.Conclusions Through this experimental limb replantation,the sea water soaked amputated limb can be replanted with routine microsurgical technique with high survival rate and satisfactory healing of bone,nerve,muscle and tendon.Ultrasonography is useful monitoring measure to inspect repair and healing process of the tendon.This experiment proves that replantation of sea water soaked amputated limb in hospital ship in the war time is feasible.更多还原