文章摘要
叶冬梅,陈琛,白跃宏,沈梅.中小功率微波照射对钛合金植入物周围组织的热损伤观察[J].中华物理医学与康复杂志,2016,38(12):942-946
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中小功率微波照射对钛合金植入物周围组织的热损伤观察
  
DOI:
中文关键词: 微波  钛合金  金属植入物  温度
英文关键词: Microwave  Titanium alloy  Metal implants  Temperature
基金项目:国家自然科学基金(81601982);大连大学博士启动专项基金(20152QL005)
作者单位
叶冬梅,陈琛,白跃宏,沈梅 116001大连大连大学附属中山医院康复科(叶冬梅、沈梅)大连大学医学院解剖学教研室(陈琛)上海交通大学附属第六人民医院(白跃宏) 
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中文摘要:
      目的观察中、小功率单次微波照射对钛合金植入物周围组织的热损伤作用。 方法通过手术将钛合金内固定物植入兔右侧股骨上段,并将该侧作为实验侧,左侧下肢相同部位作为对照侧。根据微波照射功率将实验兔分为4组,分别是20W组、40W组、60W组及80W组。各组实验兔经麻醉后分别给予相应功率微波照射(微波频率均为2450MHz,持续照射30min),实时测量微波照射区域钛合金表面及毗邻肌组织温度变化;随后采用肌电图检测各组实验兔坐骨神经复合肌肉动作电位(CMAP)情况;最后处死动物,取股骨旁钛合金周围肌组织、神经组织进行病理学检查。 结果与对照侧骨骼肌比较,经20W、40W微波照射后实验侧骨骼肌温度升高不显著(P>0.05),经60W、80W微波照射后实验侧骨骼肌温度升高显著(P<0.05)。坐骨神经电生理检查结果显示,经60W、80W微波照射后,实验侧坐骨神经CMAP潜伏期明显延长(P<0.05),神经传导速度显著变慢(P<0.05),但波幅均无明显下降(P>0.05)。病理学检查结果显示,经60W微波照射后,实验侧骨骼肌细胞间隙明显充血、出血,坐骨神经无明显病理学改变;经80W微波照射后肌细胞出现空泡,肌细胞结构遭到破坏,坐骨神经髓鞘肿胀。 结论60~80W微波(频率为2450MHz)连续照射30min可引起钛合金植入物周围组织热损伤,20~40W微波连续照射30min,钛合金植入物周围组织未见明显热损伤,提示对钛合金植入部位进行小功率微波照射安全性相对较好。
英文摘要:
      Objective To observe the influence of low or middle power microwave radiation on tissues adjacent to titanium alloy implants. MethodsTitanium alloy internal fixation plates were implanted into the upper femur of the right side of New Zealand white rabbits, the left femurs served as the control. Then the femurs were exposed to 20, 40, 60, or 80 W of microwave radiation at a frequency of 2450 MHz for 30 minutes, and real-time temperature of the implants and its adjacent muscles were recorded. The nerve conduction study of the sciatic nerve was performed by stimulating the nerve and recording from gastrocnemius in both groups. Finally, all the rabbits were sacrificed and histological studies were performed on nerve and muscle sections. ResultsCompared to the control limbs, temperatures of limbs with titanium alloy implants increased significantly when exposed to microwave radiation at 60 and 80 W (P<0.05) but no significant differences were revealed when exposed to radiation at 20 and 40 W (P<0.05). For the sciatic nerve conduction, significantly prolonged distal latency of CMAP (P<0.05) and slower nerve conduction velocity (P<0.05) were observed in the experimental limbs when exposed to microwave radiation at 60 and 80 W, but the decrease of CMAP amplitude was not significant (P>0.05). Pathological examination showed obvious congestion and bleeding in the intercellular spaces of skeletal muscle cells in the experiment group when exposed to radiation at 60 W, with no obvious pathological changes found in the sciatic nerve. However, when exposed to radiation at 80 W, vacuoles appeared in myocytes, the cellular structure was destroyed and the myelin sheath of the sciatic nerve swelled. ConclusionExposure to microwave irradiation at 20 and 40 W, but not 60 and 80 W exerts no adverse effects on nerves and muscles adjacent to titanium alloy internal fixation plates. Consequently, continuous wave microwave irradiation at low powers (20~40 W) is a safer auxiliary treatment for limbs with titanium alloy implants.
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