【摘要】：目的探討海藻酸鈉復(fù)合膠中加入硫酸軟骨素對兔骨折愈合的影響。方法新西蘭大白兔72只,適應(yīng)性喂養(yǎng)1 w,隨機(jī)分為膠1組、膠2組、絲線組和模型組,每組18只。無菌手術(shù)條件下在橈骨上造成一大小為0.8 cm×0.4 cm蝶形骨塊,其中膠1組用A膠(海藻酸鈉∶羧甲基纖維素鈉:硫酸軟骨素=6.0∶2.5∶0.75)黏接固定,膠2組用B膠(海藻酸鈉∶羧甲基纖維素鈉=6.0∶2.5)黏接固定,并在黏接處滴飽和氯化鈣溶液5滴,使膠表面形成一層海藻酸鈣膜;絲線組以4號絲線將骨塊捆扎固定;模型組將骨塊放至原位置,不做任何固定;逐層縫合切口,用無菌敷料包扎。術(shù)后2 w、4 w和6 w分別對膠1組、膠2組、絲線組、模型組拍攝X線片,觀察骨折愈合情況,然后各組于各時間段處死6只取出骨折端進(jìn)行骨痂組織切片HE染色,鏡下觀察不同時間段各組骨痂生長情況;采集骨折局部皮下組織,酶聯(lián)免疫吸附試驗(yàn)(ELISA)檢測不同時間段各組骨折局部皮下組織中骨形態(tài)發(fā)生蛋白(BMP)、白細(xì)胞介素(IL)-6含量。結(jié)果術(shù)后X線片:膠1組、膠2組術(shù)后6 w骨折骨性愈合,位線良好;絲線組骨折線基本消失,骨干外形成陳舊性骨折影;模型組骨折畸形愈合,可見明顯骨缺損。HE染色:膠1組、膠2組術(shù)后骨軟細(xì)胞成骨活躍,炎癥反較輕,絲線組和模型組肉芽組織增生明顯,炎癥反應(yīng)較重。術(shù)后2、4、6 w時骨折局部皮下組織中IL-6、BMP的ELISA檢測:骨折局部皮下組織中BMP的含量均為膠1組膠2組絲線組模型組(P0.05);IL-6的水平以絲線組最高(P0.05),膠1組、膠2組和模型組之間無統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論海藻酸鈉和羧甲基纖維素鈉的復(fù)合膠能有效黏合小骨折塊,炎癥反應(yīng)小;硫酸軟骨素能促進(jìn)骨折愈合過程中BMP的表達(dá),在海藻酸鈉和羧甲基纖維素鈉的復(fù)合膠中加入一定比例的硫酸軟骨素制成的新型骨黏合劑更有利于骨折的愈合。
[Abstract]:Objective to investigate the effect of adding chondroitin sulfate into sodium alginate compound glue on fracture healing in rabbits. Methods 72 New Zealand white rabbits were fed adaptively for 1 week. They were randomly divided into three groups: glue group (n = 18), silk thread group (n = 18) and model group (n = 18). A butterfly bone mass of 0.8 cm 脳 0.4 cm in size was created on the radius under aseptic operation condition, in which group 1 was glued and fixed with A glue (sodium alginate: sodium carboxymethyl cellulose: chondroitin sulfate 6.0: 2.5: 0.75). Group 2 was fixed with B glue (sodium alginate: sodium carboxymethyl cellulose 6.0: 2.5) and saturated calcium chloride solution (5 drops) was dripped on the adhesive to form a layer of calcium alginate film on the surface of glue. In the model group, the bone was placed in its original position without any fixation. The incision was sutured layer by layer and wrapped with aseptic dressing. At 4 and 6 weeks after operation, X-ray films were taken from glue 1 group, glue 2 group, silk thread group and model group, respectively. The healing of fracture was observed, and then 6 rats were killed at each time point to be stained with HE in callus tissue sections. Bone morphogenetic protein (BMP),) interleukin (IL) -6 (IL) -6) in local subcutaneous tissue of fracture was detected by (ELISA). Results X-ray films: the fracture bone union was good in group 1 and group 2 at 6 weeks after operation, the fracture line of silk thread group disappeared basically, the old fracture shadow formed outside the backbone, the fracture malunion of model group was observed. Obvious bone defect. HE staining: bone soft cell osteogenesis was active and inflammation was lighter in group 1 and group 2, granulation tissue proliferation and inflammatory reaction were more serious in silk thread group and model group. ELISA detection of IL-6 BMP in local subcutaneous tissue of fracture at 2 weeks and 4 weeks postoperatively: the content of BMP in local subcutaneous tissue of fracture was the highest (P0.05) in the silk thread group and the highest in the glue 1 group (P0.05), and the level of IL-6 was the highest in the glue group (P0.05), and the level of IL-6 in the glue group was the highest (P0.05), the level of IL-6 in the glue group was the highest (P0.05). There was no statistical difference between glue 2 group and model group (P0.05). Conclusion the composite adhesive of sodium alginate and sodium carboxymethyl cellulose can effectively bind to the small fracture block and the inflammatory reaction is small, and chondroitin sulfate can promote the expression of BMP during fracture healing. Adding a certain proportion of chondroitin sulfate to the composite adhesive of sodium alginate and sodium carboxymethyl cellulose is more beneficial to fracture healing.
【作者單位】： 廈門市第二醫(yī)院;福建中醫(yī)藥大學(xué);廈門市中醫(yī)院;
【基金】：福建省衛(wèi)生教育聯(lián)合攻關(guān)項(xiàng)目(WKJ2008-2-38)
【分類號】：R683
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本文編號：2141901