射頻能量對(duì)關(guān)節(jié)軟骨細(xì)胞活性的實(shí)驗(yàn)研究

肖建華

[摘要]目的 研究射頻能量對(duì)關(guān)節(jié)軟骨細(xì)胞活性的影響效果，進(jìn)而驗(yàn)證該方法臨床可行性。方法 選取10對(duì)牛關(guān)節(jié)軟骨中的5對(duì)作為射頻能量的實(shí)驗(yàn)對(duì)象，每對(duì)兩側(cè)分為4個(gè)單元格，其中3個(gè)單元格作為研究組，分別對(duì)應(yīng)SCULPTOR單極射頻頭、SAPHYRE雙極射頻頭、TAC-C Ⅱ軟骨溫控頭，處理的時(shí)間設(shè)定為1 min，剩余1個(gè)單元格作為對(duì)照組，不做射頻處理。取剩下的5對(duì)牛關(guān)節(jié)軟骨作為處理時(shí)間的實(shí)驗(yàn)對(duì)象，分別使用SAPHYRE雙極射頻頭以5、10、20、30 s進(jìn)行射頻處理，其中4組作為研究組，剩余1組不作處理，作為對(duì)照組。觀察研究組與對(duì)照組蘇木精-伊紅染色（簡(jiǎn)稱HE染色）、熒光染色和GAG釋出率測(cè)定數(shù)值的差異，分析其細(xì)胞活性和組織受損情況的差異。結(jié)果 SCULPTOR單極射頻頭組、SAPHYRE雙極射頻頭組、TAC-C Ⅱ軟骨溫控頭組的細(xì)胞HE染色、熒光染色的空泡率和死亡率均顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；第1天，SCULPTOR單極射頻頭組、SAPHYRE雙極射頻頭組、TAC-C Ⅱ軟骨溫控頭組的軟組織GAG釋出率顯著低于對(duì)照組，第2、3天，SAPHYRE雙極射頻頭組、TAC-C Ⅱ軟骨溫控頭組的軟組織GAG釋出率顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；采用5、10、20、30 s時(shí)間處理組的細(xì)胞HE染色、熒光染色的空泡率和死亡率均顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；第1、2、3天，采用5、10、20、30 s時(shí)間處理組的軟組織GAG釋出率均顯著低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 射頻能量和處理時(shí)間的增加都會(huì)導(dǎo)致關(guān)節(jié)軟組織受損，且與增加數(shù)值成正相關(guān)，因此需要適當(dāng)降低射頻能量和處理時(shí)間，避免治療時(shí)對(duì)患者形成組織損傷。

[關(guān)鍵詞]射頻能量；關(guān)節(jié)軟骨；細(xì)胞活性；蘇木精-伊紅染色；GAG釋出率

[中圖分類號(hào)] R681.53 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2018）7（c）-0120-04

[Abstract] Objective To study the effect of radiofrequency energy on the cell activity of articular cartilage， so as to verify the clinical feasibility of this technique. Methods A total of 10 pairs of bovine articular cartilage were selected，of which five pairs were used as radiofrequency energy subjects. The sides of each pair were divided into four table cells， of which three ones were for research， respectively corresponding to SCULPTOR monopolar radiofrequency head， SAPHYRE bipolar radiofrequency head， and TAC-C Ⅱ cartilage temperature-controlled head for 1 min. The remaining one was as a control without radiofrequency. The rest five pairs were selected as experimental subjects in different processing time （5， 10， 20， and 30 second）， of which four pairs disposed with SAPHYRE bipolar radiofrequency head were selected as the research group and the last one without disposal was selected as the control group. The above-mentioned research groups and control groups were compared in order to observe the differences of hematoxylin-eosin staining （HE staining）， fluorescence staining， and GAG release rate， and the differences of cell activity and tissue damage were analyzed. Results The vacuolization rate and mortality rate of the HE staining and fluorescence staining in the SCULPTOR monopolar radiofrequency head group， the SAPHYRE bipolar radiofrequency head group， and the TAC-C Ⅱ cartilage temperature-controlled head group were significantly higher than those of the control group， and the differences were statistically significant （P<0.05）. On the first day， the soft tissue GAG release rate in the SCULPTOR monopolar radiofrequency head group， the SAPHYRE bipolar radiofrequency head group， and the TAC-C Ⅱ cartilage temperature-controlled head group was significantly lower than that in the control group； on the second and third days， the GAG release rate of soft tissue of the SAPHYRE bipolar radiofrequency head group and the TAC-C Ⅱ cartilage temperature-controlled head group was significantly lower than that of the control group， and the differences were statistically significant （P<0.05）. The vacuolization rate and the mortality rate of the HE staining and fluorescence staining in the 5， 10， 20， and 30 s treatment groups were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. On the first， second， and third days， the GAG release rate of soft tissue in the 5， 10， 20， and 30 s treatment groups were significantly lower than that in the control group， and the differences were statistically significant （P<0.05）. Conclusion The increase of radiofrequency energy and processing time both will lead to the damage of the joint soft tissue in a positive correlation. Therefore， it is necessary to appropriately reduce the radiofrequency energy and processing time in order to avoid tissue damage in patients during treatment.