摘要
目的探究β-磷酸三钙对同种异体骨与带血管自体腓骨嵌套式复合骨移植修复大段骨缺损疗效的影响。方法选取16只健康6个月龄新西兰大白兔，随机分为实验组和对照组（n=8），均于胫骨中上段建立长为15mm的大段骨缺损模型，使用同种异体骨与带血管自体腓骨嵌套式复合骨移植进行修复。实验组在异体骨与自体腓骨之间填充β-磷酸三钙颗粒，对照组不填充。术后当天、8周、12周行X线检查观察骨愈合情况，术后1、8、12周行骨移植区域骨密度检测，术后8、12周取材行组织学染色观察，对比两组的骨修复效果。结果所有动物均存活至观察时间点，伤口愈合良好，未见伤口感染或不愈合的发生。X线检查显示术后8、12周实验组骨愈合均较对照组明显。实验组：与术后1周的骨密度[（0．171±0．016）g／cm2]比较，术后8周[（0．293±0．014）g／cm2]有所升高，但术后12周[（0．274±0．014）g／cm2]较术后8周又有所下降，差异均有统计学意义（P〈0．05）；对照组：与术后1周[（0．154±0．011）g／cm2]相比，术后8周[（0．211±0．008）g／cm2]上升，术后12周[（0．235±0．010）g／cm2]提高更明显，差异均有统计学意义（P〈0．05）。术后8、12周对照组骨密度均低于实验组，差异有统计学意义（P〈0．05）。组织学观察结果：术后8、12周实验组移植区两端及髓腔内均有新骨形成连接，异体骨和自体骨结合紧密；而对照组移植区两端和髓腔内新生骨很少，异体骨和自体骨之间分离明显。结论同种异体骨与带血管自体骨嵌套式复合移植联合B一磷酸三钙颗粒填充可加速新生骨组织的形成，促进大段骨缺损的骨修复效果，弥补传统嵌套式复合骨移植的不足。
Objective To study the influence of β-calcium phosphate on the repair of large bone defects using nested composite bone graft of allogeneic bone and vascular autograft bone. Methods Sixteen New Zealand rabbits of 6 months old were randomly divided into 2 equal groups （ n = 8） . Models of 15 mm large bone defect were created on the middle and upper shaft of the fight tibia in all the rabbits. The defects were repaired using nested composite bone graft of allogeneic bone and vascular autograft bone. The gap between the allogeneic bone and the autograft bone in the composite bone graft was filled with β-calcium phosphate in the experimental group but not filled in the control group. X-ray examination was conducted to observe fracture healing on the fight postoperative day and 8 and 12 weeks after operation; examination of bone mineral density in the bone defect area was conducted at 1, 8 and 12 weeks after operation; histological observation of samples was made at 8 and 12 weeks after operation. The 2 groups were compared regarding the effect of β-calcium phosphate on the repair of bone defects. Results All the animals survived till the observation time and their wounds healed well without any infection. X-ray showed better bone union in the experimental group than in the control group at 8 and 12 months after operation. In the experimental group, the bone mineral density at one week（0. 171 ± 0. 016 g/cm2） increased significantly at 8 weeks（0. 293 ± 0. 014 g/cm2） but decreased significantly at 12 weeks （0. 274 ± 0. 014 g/cm2） （ P 〈 0. 05） ; in the control group, the bone mineral density at one week （0. 154 ±0. 011 g/cm2） increased significantly at 8 weeks（0. 211 ±0. 008 g/cm2） and increased significantly still higher at 12 weeks （0. 235 ± 0. 010 g/cm2） （ P 〈 0. 05）. At 8 and 12 weeks, the bone mineral density in the control group was significantly lower than in the experimental group（ P 〈 0. 05）. Histological detection showed that massive new bone formed in the composite bone graft in the experimental group at 8 and 12 weeks after operation while little new bone formed in the bone defect area and there was a distinct gap between the allogeneic bone and the autograft bone in the control group. Conclusion As filling of β-calcium phosphate particles can accelerate formation of new bone callus to promote healing of long bone defects, it makes up for the shortcoming of conventional nested composite bone graft of allogeneic bone and vascular autograft bone.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第1期75-80,共6页
Chinese Journal of Orthopaedic Trauma
基金
总后勤部卫生部专项课题（13CXZ054）
关键词
移植
自体
修复外科手术
动物实验
Β-磷酸三钙
大段骨缺损
Transplantation, autologous
Reconstructive surgical procedures
Animal experimentation
β-calcium phosphate
Large bone defects
