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帶血供骨膜瓣復(fù)合去抗原異種松質(zhì)骨修復(fù)兔橈骨骨缺損的實(shí)驗(yàn)研究

發(fā)布時(shí)間:2018-10-10 10:43
【摘要】:目的:探討帶血供骨膜瓣復(fù)合去抗原異種松質(zhì)骨修復(fù)兔橈骨骨缺損的效能。方法:在60只新西蘭大白兔雙側(cè)橈骨中段制造1.5 cm長骨缺損模型,其中30只動(dòng)物一側(cè)設(shè)為A組,骨缺損處植入去抗原異種松質(zhì)骨后表面以帶血供骨膜瓣覆蓋;另一側(cè)設(shè)為B組,骨缺損處單純植入去抗原異種松質(zhì)骨。剩余30只動(dòng)物一側(cè)設(shè)為C組,骨缺損處僅植入帶血供骨膜瓣;另一側(cè)設(shè)為D組,骨缺損處既不植入帶血供骨膜瓣也不植入去抗原異種松質(zhì)骨。A、B、C、D四組60只動(dòng)物分別于術(shù)后4周,10周,16周各取20只動(dòng)物進(jìn)行正位X射線檢查后空氣栓塞處死,大體觀察雙側(cè)骨缺損處組織變化情況,再以0.5 cm為樣本長度取材,進(jìn)行蘇木精-伊紅染色光鏡觀察與生物力學(xué)測試,根據(jù)Lane-Sandhu X射線評分標(biāo)準(zhǔn)與Lane-Sandhu骨移植組織學(xué)評分標(biāo)準(zhǔn)計(jì)算各組得分。A組均數(shù)分別與B、C、D三組均數(shù)比較,采用配對t檢驗(yàn),顯著性水準(zhǔn)設(shè)為0.05。結(jié)果:大體觀察、X射線檢查、HE染色光鏡觀察結(jié)果顯示,術(shù)后4周,10周,16周在新骨的生成、結(jié)構(gòu)塑形與去抗原異種松質(zhì)骨降解方面A組均優(yōu)于B組,根據(jù)Lane-Sandhu X射線評分標(biāo)準(zhǔn)與Lane-Sandhu骨移植組織學(xué)評分標(biāo)準(zhǔn),A組評分高于B組(P0.05)。生物力學(xué)測試結(jié)果顯示,術(shù)后4周,10周,16周A組最大負(fù)荷/位移比值高于B組(P0.05)。X射線檢查結(jié)合大體觀察結(jié)果顯示C、D兩組術(shù)后4周骨缺損處均被纖維組織填充,無新骨生成,兩骨端吸收,術(shù)后10周骨缺損處均被大量瘢痕組織填充,僅少量骨痂生成,兩骨端萎縮。術(shù)后16周骨缺損處均被瘢痕組織填充,兩骨端錐形成骨,髓腔封閉,與尺骨融合,無骨性連接,均未行X射線評分與取材。結(jié)論:帶血供骨膜瓣復(fù)合去抗原異種松質(zhì)骨移植修復(fù)兔橈骨骨缺損能力強(qiáng)于單純?nèi)タ乖惙N松質(zhì)骨移植,新成骨具有較好的生物學(xué)結(jié)構(gòu)與功能。
[Abstract]:Objective: to investigate the efficacy of blood supply periosteum flap combined with xenogeneic cancellous bone in repairing rabbit radius defect. Methods: a 1. 5 cm long bone defect model was established in 60 New Zealand white rabbits with bilateral radial midsection. 30 animals were divided into group A, the posterior surface of cancellous bone with antigenic xenogeneic cancellous bone was covered with a blood supply periosteum flap, and the other side was set as group B. The cancellous bone with antigenic xenograft was simply implanted at the bone defect. The remaining 30 animals were divided into group C, the bone defect was only implanted with blood supply periosteum flap, and the other side was set as group D, No periosteal flap with blood supply and no antigenic xenogeneic cancellous bone were implanted in bone defect. 60 animals in group D were killed by air embolization after 4 weeks and 10 weeks and 16 weeks, respectively, after orthotopic X-ray examination, 20 animals were killed by air embolization. The tissue changes of bilateral bone defects were observed in general. The length of the sample was taken as the sample length of 0. 5 cm. The light microscope observation and biomechanical test were performed with hematoxylin-eosin staining. According to Lane-Sandhu X-ray score and Lane-Sandhu bone graft histological score, the scores of group A were compared with those of group D, and the significant level was set to 0.05 by paired t test. Results: gross X-ray examination and HE staining showed that group A was superior to group B in the formation of new bone, structural remodeling and degradation of xenogeneic cancellous bone at 4 weeks to 10 weeks and 16 weeks after operation. According to Lane-Sandhu X ray score and Lane-Sandhu bone graft histological score, group A was higher than group B (P 0.05). The results of biomechanical test showed that the maximum load / displacement ratio of group A was higher than that of group B (P0.05). X-ray examination combined with gross observation showed that the bone defect was filled with fibrous tissue and no new bone formation was found in group C and D at 4 weeks and 16 weeks after operation. At 10 weeks after operation, the bone defect was filled with a large number of scar tissue, only a small amount of callus was formed, and the two bone ends were atrophied. At 16 weeks after operation, the bone defect was filled with scar tissue, the two bony ends were conical osteogenesis, the medullary cavity was closed, fusion with ulna, no bone connection, no X-ray score and material were taken. Conclusion: the composite xenogeneic cancellous bone graft with blood supply periosteum flap is better than simple xenogeneic cancellous bone graft in repairing rabbit radius defect. The new osteogenesis has better biological structure and function.
【學(xué)位授予單位】:第二軍醫(yī)大學(xué)
【學(xué)位級別】:碩士
【學(xué)位授予年份】:2015
【分類號(hào)】:R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 袁志,馬平,胡蘊(yùn)玉,韓一生,羅卓荊,李丹,王軍;兔脛骨骨膜大部分切除對脛骨結(jié)構(gòu)的影響[J];第四軍醫(yī)大學(xué)學(xué)報(bào);2002年24期

2 路青林,韓建波,李樹鋒,劉慶勝;交鎖髓內(nèi)釘聯(lián)合骨瓣、骨膜瓣治療四肢骨不連及骨缺損[J];骨與關(guān)節(jié)損傷雜志;2004年02期

3 李衛(wèi)國,黃向紅,唐景清,何勇;自體骨膜游離移植的實(shí)驗(yàn)研究——不同齡動(dòng)物大塊關(guān)節(jié)軟骨缺損修復(fù)的比較[J];中華創(chuàng)傷骨科雜志;2005年09期

4 王嘉寧,張世斌;小腿內(nèi)側(cè)脛骨骨膜皮瓣移植術(shù)[J];中國矯形外科雜志;2004年Z3期

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