本文關(guān)鍵詞： 骨缺損 股骨 明膠 羥基磷灰石 米諾環(huán)素 鈦網(wǎng) 兔　出處：《山東醫(yī)藥》2017年32期 　論文類型：期刊論文

【摘要】：目的探討明膠-羥基磷灰石-米諾環(huán)素(Gel-HA-M)復(fù)合材料聯(lián)合鈦網(wǎng)固定對(duì)兔股骨缺損的修復(fù)作用。方法將30只雄性新西蘭大白兔隨機(jī)分為復(fù)合材料組、自體骨對(duì)照組及空白對(duì)照組,每組10只。三組均建立股骨缺損模型(缺損長度12~15 mm),復(fù)合材料組植入Gel-HA-M復(fù)合材料聯(lián)合鈦網(wǎng)固定,自體骨對(duì)照組植入自體股骨聯(lián)合鈦網(wǎng)固定,空白對(duì)照組僅行鈦網(wǎng)固定。三組分別于術(shù)后4、8、12周隨機(jī)選取3、3、4只兔,處死后取出股骨行大體觀察、X線檢查,HE染色后觀察組織病理情況。結(jié)果術(shù)后4周:復(fù)合材料組植入材料與周圍骨組織界限稍模糊,X線檢查顯示鈦網(wǎng)周圍無明顯骨痂形成,HE染色可見片狀、條索狀、網(wǎng)狀軟骨樣基質(zhì)形成;自體骨對(duì)照組可見自體骨與斷端部分愈合,X線檢查顯示鈦網(wǎng)周圍無明顯骨痂形成,HE染色可見大量網(wǎng)狀編織骨形成;空白對(duì)照組有2只存在感染跡象,X線檢查顯示鈦網(wǎng)周圍無明顯骨痂形成,HE染色未見連續(xù)性骨樣基質(zhì)形成。術(shù)后8周:復(fù)合材料組植入材料的硬度與周圍骨組織接近,X線檢查顯示鈦網(wǎng)周圍骨痂逐漸增多,HE染色可見新生骨組織明顯增多,形成網(wǎng)狀致密的骨小梁組織;自體骨對(duì)照組骨缺損處基本愈合,X線檢查顯示鈦網(wǎng)周圍骨痂逐漸增多,HE染色可見新生骨組織進(jìn)一步成熟,骨組織鈣化較之前增強(qiáng);空白對(duì)照組未形成骨性愈合,X線檢查顯示鈦網(wǎng)周圍無明顯骨痂形成,HE染色未見連續(xù)性骨樣基質(zhì)形成。術(shù)后12周:復(fù)合材料組骨缺損區(qū)已達(dá)到骨性愈合,X線檢查顯示鈦網(wǎng)周圍大量骨痂形成、兩斷端連接,HE染色可見新生骨組織逐漸成熟,伴髓腔形成;自體骨對(duì)照組骨缺損區(qū)基本達(dá)到骨性愈合,X線檢查顯示鈦網(wǎng)周圍大量骨痂形成、兩斷端連接,HE染色可見編織樣骨組織趨于有序性排列;空白對(duì)照組斷端仍未形成骨性連接,X線檢查顯示鈦網(wǎng)周圍少量骨痂形成,HE染色未見連續(xù)性骨樣基質(zhì)形成,伴有纖維結(jié)締組織及炎性細(xì)胞大量增生。結(jié)論 Gel-HA-M復(fù)合材料聯(lián)合鈦網(wǎng)固定對(duì)兔股骨缺損的修復(fù)效果與自體骨的修復(fù)效果相當(dāng),并有助于減少感染發(fā)生,是一種效果較好的人工合成骨缺損修復(fù)材料。
[Abstract]:Objective to study Gel-HA-M of gelatin, hydroxyapatite and minocycline. Methods 30 male New Zealand white rabbits were randomly divided into composite group and composite group. The femur defect model was established in each group with 10 rats in the autogenous bone control group and 10 in the blank control group (the length of the defect was 1215 mm). Gel-HA-M composite material combined with titanium mesh fixation was implanted in the composite group, autogenous femur combined with titanium mesh fixation was implanted in the autologous bone control group, and titanium mesh fixation was only performed in the blank control group. After 12 weeks, 3 rabbits were randomly selected and the femur was taken out for gross observation and X-ray examination. Results at 4 weeks after HE staining, the boundary between the implanted material and the surrounding bone tissue in the composite group was slightly blurred and X-ray examination showed that there was no obvious callus formation around the titanium mesh. Strip, reticular chondroid matrix formation; X-ray examination showed that there was no obvious callus formation around the titanium mesh in the autologous bone control group and a large number of reticular braided bones were found in HE staining. In the blank control group, there were 2 cases of infection. X-ray examination showed that there was no obvious callus formation around the titanium mesh. There was no continuous bone like matrix formation in HE staining. 8 weeks after operation, the hardness of the composite material was close to that of the surrounding bone tissue. X-ray examination showed that the callus around the titanium mesh increased gradually. He staining showed that the number of new bone tissue was obviously increased, and the meshwork was formed in the form of dense bone trabeculae. X-ray examination of bone defect in autogenous bone control group showed that the callus around titanium mesh increased gradually. He staining showed that the new bone tissue matured further and the calcification of bone tissue was enhanced. X-ray examination showed that there was no obvious callus formation around titanium mesh and no continuous bone like matrix formation was observed in the blank control group. 12 weeks after operation, bone healing was achieved in the bone defect area of the composite group. X-ray examination showed that a large number of callus formed around the titanium mesh, and HE staining showed that the new bone tissue matured and the medullary cavity formed. X-ray examination showed that a large number of callus formed around the titanium mesh, and HE staining of the two broken ends showed that the braided bone tissue tended to be arranged orderly. X-ray examination showed that a small amount of callus formed around the titanium mesh and no continuous bone like matrix was formed by HE staining in the blank control group. Conclusion the effect of Gel-HA-M composite combined with titanium mesh fixation on repairing femoral defect in rabbits is similar to that of autogenous bone. It is helpful to reduce the incidence of infection and is a good synthetic bone defect repair material.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院;安徽醫(yī)科大學(xué)附屬口腔醫(yī)院;安徽醫(yī)科大學(xué)第二附屬醫(yī)院;
【基金】：安徽省科技攻關(guān)計(jì)劃項(xiàng)目(1301042096)
【分類號(hào)】：R687.3
【正文快照】： 3安徽醫(yī)科大學(xué)第二附屬醫(yī)院)近年來因創(chuàng)傷骨折、感染和骨腫瘤等引起的骨缺損患者日益增多,而較大的骨缺損常常無法自我修復(fù)[1]。臨床上常用自體骨移植或者用同種異體骨和動(dòng)物源性的異種骨移植來修復(fù)骨缺損,但自體骨移植取材量有限且存在二次傷害[2,3],同種異體骨和動(dòng)物源性的

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