本文選題：多孔鉭　切入點(diǎn)：筋膜瓣　出處：《中國(guó)修復(fù)重建外科雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的觀察帶蒂筋膜瓣包裹國(guó)產(chǎn)多孔鉭修復(fù)兔橈骨節(jié)段性骨缺損的成骨效果。方法選取6~8月齡成年新西蘭大白兔60只,雌雄不限,體質(zhì)量2.5~3.0 kg;制備兔右側(cè)橈骨中段連同骨膜1.5 cm骨缺損模型。實(shí)驗(yàn)分為2組,每組30只。實(shí)驗(yàn)組于兔右側(cè)前肢切取皮下帶蒂筋膜瓣(30 mm×20 mm)包裹多孔鉭棒植入橈骨缺損處,對(duì)照組于右側(cè)橈骨骨缺損處植入單純多孔鉭棒。于術(shù)后當(dāng)日及4、8、16周行X線片觀察,術(shù)后4、8、16周取材切片行HE染色及甲苯胺藍(lán)染色觀察,術(shù)后16周行三點(diǎn)彎曲生物力學(xué)測(cè)定標(biāo)本最大載荷力及抗彎曲強(qiáng)度,并行Micro-CT檢測(cè)及定量分析骨缺損處新生骨體積分?jǐn)?shù)(bone volume fraction,BV/TV),比較兩組多孔鉭棒體內(nèi)骨缺損修復(fù)能力。結(jié)果術(shù)后切口均Ⅰ期愈合,無(wú)切口感染發(fā)生。術(shù)后4、8、16周X線片可見(jiàn)兩組植入物與宿主骨界面結(jié)合越來(lái)越牢固,無(wú)明顯位移,骨折線逐漸消失。HE染色及甲苯胺藍(lán)染色示兩組鉭-骨界面新生骨組織數(shù)量逐漸增多,并沿多孔鉭孔隙長(zhǎng)入材料內(nèi)部,骨組織由幼稚到成熟。術(shù)后16周,兩組三點(diǎn)彎曲試驗(yàn)測(cè)定結(jié)果示,實(shí)驗(yàn)組最大載荷力和抗彎曲強(qiáng)度分別為(96.54±7.21)N、(91.26±1.76)MPa,均明顯大于對(duì)照組[分別為(82.65±5.65)N、(78.53±1.16)MPa](t=3.715,P=0.004;t=14.801,P=0.000)。Micro-CT掃描觀察兩組植入物界面、表面均有大量骨組織覆蓋,內(nèi)部不同程度新生骨組織填充;實(shí)驗(yàn)組新生骨BV/TV為32.63%±3.56%,顯著高于對(duì)照組的25.07%±4.34%(t=3.299,P=0.008)。結(jié)論帶蒂筋膜瓣包裹國(guó)產(chǎn)多孔鉭可增加局部血運(yùn),增強(qiáng)材料骨傳導(dǎo)能力,促進(jìn)節(jié)段性骨缺損修復(fù)。
[Abstract]:Objective to observe the osteogenic effect of porous tantalum coated with pedicled fascia flap on rabbit radial segmental bone defect. Methods 60 adult New Zealand white rabbits aged 6 ~ 8 months, male and female, were selected. The animal model of bone defect in the middle segment of the right radius with 1.5 cm periosteum was established. The experimental group was divided into two groups, 30 in each group. The experimental group was divided into two groups. The experimental group was divided into two groups. The experimental group was divided into two groups. The experimental group was divided into two groups. The experimental group was divided into two groups. The experimental group was divided into two groups. In the control group, pure porous tantalum rods were implanted at the defect of the right radius. X-ray films were observed on the day after operation and at 816 weeks after operation, and sections were taken from the sections at 816 weeks after operation for HE staining and toluidine blue staining. The maximum load force and bending strength of the specimen were measured by three point bending biomechanics 16 weeks after operation. Bone volume fraction in bone defect was detected and quantitatively analyzed by Micro-CT. The repair ability of bone defect was compared between the two groups. Results all the incisions were healed in the first stage after operation. No incision infection occurred. X-ray films showed that the interface between the implants and the host bone was more and more firm, and there was no obvious displacement between the implants and the host bone. The results of HE staining and toluidine blue staining showed that the number of new bone tissue in tantalum bone interface increased gradually, and the bone tissue grew into the material along the porous tantalum pore, and the bone tissue grew from infantile to mature 16 weeks after operation. The results of three-point bending test in the two groups showed that the maximum load force and bending strength of the experimental group were 96.54 鹵7.21 Nou 91.26 鹵1.76 mpa, respectively, which were significantly higher than that of the control group [78.53 鹵1.16 MPA] of the two groups. The BV/TV of nascent bone in the experimental group was 32.63% 鹵3.56, which was significantly higher than that in the control group (25.07% 鹵4.34). Conclusion the porous tantalum coated with pedicled fascia flap can increase local blood flow, enhance bone conduction ability and promote segmental bone defect repair.
【作者單位】： 華北理工大學(xué)附屬唐山骨科醫(yī)院手外科;華北理工大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖系;華北理工大學(xué)附屬唐山骨科醫(yī)院關(guān)節(jié)科;華北理工大學(xué)附屬醫(yī)院骨科;華北理工大學(xué)醫(yī)學(xué)實(shí)驗(yàn)研究中心;
【基金】：國(guó)家科技部科技支撐課題資助項(xiàng)目(2012BAE06B03) 河北省科技支撐課題資助項(xiàng)目(16277776D) 河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃資助項(xiàng)目(20160225)~~
【分類號(hào)】：R687.3

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