發(fā)布時間：2018-10-10 10:43

【摘要】：目的:探討帶血供骨膜瓣復合去抗原異種松質骨修復兔橈骨骨缺損的效能。方法:在60只新西蘭大白兔雙側橈骨中段制造1.5 cm長骨缺損模型,其中30只動物一側設為A組,骨缺損處植入去抗原異種松質骨后表面以帶血供骨膜瓣覆蓋;另一側設為B組,骨缺損處單純植入去抗原異種松質骨。剩余30只動物一側設為C組,骨缺損處僅植入帶血供骨膜瓣;另一側設為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骨。A、B、C、D四組60只動物分別于術后4周,10周,16周各取20只動物進行正位X射線檢查后空氣栓塞處死,大體觀察雙側骨缺損處組織變化情況,再以0.5 cm為樣本長度取材,進行蘇木精-伊紅染色光鏡觀察與生物力學測試,根據(jù)Lane-Sandhu X射線評分標準與Lane-Sandhu骨移植組織學評分標準計算各組得分。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,顯著性水準設為0.05。結果:大體觀察、X射線檢查、HE染色光鏡觀察結果顯示,術后4周,10周,16周在新骨的生成、結構塑形與去抗原異種松質骨降解方面A組均優(yōu)于B組,根據(jù)Lane-Sandhu X射線評分標準與Lane-Sandhu骨移植組織學評分標準,A組評分高于B組(P0.05)。生物力學測試結果顯示,術后4周,10周,16周A組最大負荷/位移比值高于B組(P0.05)。X射線檢查結合大體觀察結果顯示C、D兩組術后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。結論:帶血供骨膜瓣復合去抗原異種松質骨移植修復兔橈骨骨缺損能力強于單純去抗原異種松質骨移植,新成骨具有較好的生物學結構與功能。
[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.
【學位授予單位】：第二軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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本文編號：2261468