發(fā)布時間：2018-06-15 00:25

  本文選題：骨釘 + 羥基磷灰石�。� 參考：《中國組織工程研究》2017年14期

【摘要】：背景:脛骨作為人體開放性骨折的好發(fā)部位,髓內(nèi)固定已成為治療的首選,但其術(shù)后感染的風(fēng)險較高且處理較為棘手,從而限制了內(nèi)固定的使用。目的:探討載萬古霉素-羥基磷灰石涂層鈦髓內(nèi)釘對兔股骨開放性骨折帶菌傷口模型感染的治療作用。方法:運用仿生溶液生長法,制備3種不同抗生素質(zhì)量濃度的載萬古霉素-羥基磷灰石涂層髓內(nèi)釘,并在體外進(jìn)行抑菌實驗。取健康雄性新西南大白兔40只,制作股骨中段開放性骨折細(xì)菌污染模型,根據(jù)植入髓內(nèi)釘不同分為普通髓內(nèi)釘組(n=10)以及低、中、高3種不同濃度載萬古霉素-羥基磷灰石涂層髓內(nèi)釘組(n=10)。動態(tài)觀察動物傷口外觀,監(jiān)測實驗動物的體質(zhì)量、肛溫、靜脈血中白細(xì)胞、C-反應(yīng)蛋白含量,定期對骨折周圍軟組織行病理學(xué)檢查及傷肢X射線片檢查。結(jié)果與結(jié)論:(1)實驗制備的載萬古霉素-羥基磷灰石涂層髓內(nèi)釘在體外具有明顯的抑菌性能;(2)在造模后第3天普通髓內(nèi)釘組肛溫顯著高于萬古霉素-羥基磷灰石組(P0.05);(3)低、中、高濃度萬古霉素-羥基磷灰石組兔造模后第3,7,14,28天靜脈血中白細(xì)胞、C-反應(yīng)蛋白顯著低于普通髓內(nèi)釘組(P0.05);(4)造模后骨折周圍組織病理學(xué)蘇木精-伊紅染色顯示載萬古霉素-羥基磷灰石涂層組在各時間點其炎癥反應(yīng)程度明顯低于普通髓內(nèi)釘組;(5)傷肢X射線顯示普通髓內(nèi)釘組骨痂生長緩慢伴死骨形成,載萬古霉素-羥基磷灰石涂層組骨痂生長明顯好于同期普通髓內(nèi)釘組;(6)結(jié)果表明,載萬古霉素-羥基磷灰石涂層髓內(nèi)釘在治療動物開放性股骨骨折細(xì)菌污染模型時能有效降低術(shù)后感染的發(fā)生。
[Abstract]:Background: tibia is the most common site of open fracture in human body. Intramedullary fixation has become the first choice in treatment, but the risk of infection is higher and the treatment is more difficult, which limits the use of internal fixation. Objective: to investigate the therapeutic effect of vancomycin-hydroxyapatite-coated titanium intramedullary nail on bacterial wound infection of open fracture of femur in rabbits. Methods: three kinds of vancomycin-hydroxyapatite coated intramedullary nails with different antibiotic concentrations were prepared by bionic solution growth method. The bacterial contamination model of open fracture of femur was made in 40 healthy male new southwest white rabbits. According to the intramedullary nail implantation, the rabbits were divided into two groups: normal intramedullary nail group (n = 10), low and middle bone marrow nail group (n = 10). High concentration of vancomycin-hydroxyapatite coated intramedullary nail group. The appearance of the wound was observed dynamically, the body weight, anus temperature, the content of leukocyte C-reactive protein in venous blood, the pathological examination of soft tissue around the fracture and X-ray examination of the injured limb were carried out regularly. Results and conclusion the vancomycin-hydroxyapatite coated intramedullary nail prepared by the experiment had obvious bacteriostasis in vitro. The anus temperature of the common intramedullary nail group was significantly higher than that of the vancomycin hydroxyapatite group on the 3rd day after the model was made, and the anus temperature of the common intramedullary nail group was significantly higher than that of the vancomycin hydroxyapatite group. In high concentration vancomycin-hydroxyapatite group, the leukocyte C-reactive protein in venous blood was significantly lower than that in the common intramedullary nail group on the 28th day after modeling.) the histopathological changes of hematoxylin and eosin around the fracture were observed by hematoxylin and eosin staining. The degree of inflammation in the prime-hydroxyapatite coating group was significantly lower than that in the common intramedullary nail group at each time point. X ray showed that the callus of the common intramedullary nail group grew slowly and the dead bone formed. The callus growth of vancomycin-hydroxyapatite coated group was better than that of common intramedullary nail group (6). Vancomycin-hydroxyapatite-coated intramedullary nail can effectively reduce the incidence of postoperative infection in the treatment of animal model of bacterial contamination of open femoral fractures.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院骨與關(guān)節(jié)外科;
【基金】：瀘州市科技局項目(2011-S-39(3/6))~~
【分類號】：R318.08;R683

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