摘要
目的:观察应用自体骨泥混入骨膜碎片修复骨缺损的效果,并与单纯自体骨泥植骨修复,骨缺损的效果作比较。方法:实验于2004-10/2005-02在广西医科大学第四附属医院骨科实验室完成。选择新西兰白兔12只,建立双侧桡骨中段1.5cm×0.3cm的骨缺损。实验侧(左侧)将髂骨制成的骨泥与髂骨内板骨膜剪成的碎片相混匀后取0.5g植入骨缺损处,对照侧用松质骨骨泥0.5g植入,于术后2,4,6,8,10,12周分别摄X射线片并在麻醉状态下每次处死2只,于骨缺损处两端剪断桡骨,完整取出骨缺损段,分析天平称重,双侧对比,光镜和电镜下观察组织学情况。结果:纳入12只白兔均进入结果分析。①术后12周平均骨质量比较:实验侧明显高于对照侧[(1.31±0.05,1.12±0.03)g,(P<0.05)]。②术后平均骨愈合时间比较:实验侧明显低于对照侧[(3.66±0.30,4.25±0.55)周,(P<0.05)]。③光镜下检查结果:4周实验侧除了有大量的新生骨细胞外,开始出现较多的骨小梁等正常结构,对照侧的骨小梁结构较实验侧少;实验侧和对照侧在6周以后的骨痂已经有了正常的骨结构,骨细胞均匀,骨小梁排列整齐。④电镜检查结果:术后2周实验侧与对照侧骨痂组织中均有大量的胶原纤维,在实验侧发现正常的骨祖细胞,而对照侧未发现;4周时实验侧可见较成熟的骨细胞,而对照侧所见到的骨细胞发育较差;两侧6周以后的骨痂组织中均有正常的骨细胞。结论:自体骨泥混入骨膜碎片后成骨愈合能力较单纯自体骨泥植骨明显增强,可提高骨质量,缩短骨愈合时间,促进骨细胞的发育,具有方法简单、不增加手术难度和创伤,效果可靠等优点,为临床工作提供了一种新的植骨方法。
AIM： To observe the effect of repairing bone defect with autogenous bone dust mixed periosteous pieces and compare with the effect of single bone dust so as to seek a good method for treating bone defect. METHODS： The experiment was conducted in the laboratory of Department of Orthopaedics, Fourth Affiliated Hospital of Guangxi Medical University from October 2004 to February 2005. A 1.5 cm×0.3 cm bony defect was established in 12 experimental rabbits one each in each side of radius. Each bony defect of left side was repaired with mixture （0.5 g） of autogenous bone dust and periosteous pieces as experimental group. Each bony defect of right side was repaired with single bone dust of spongy bone （0.5 g） as control group. X-ray plain films were taken 2, 4, 6, 8, 10, and 12 weeks after surgery, and 2 rabbits were killed each time under the state of anesthesia. Radii of two sides were cut off completely. The weight of each sample was measured by analytical balance and then the histological morphology of each sample was observed by light microscope and electron microscope. RESULTS： Twelve rabbits involved entered the result analysis. ①Comparison of bone mass 12 weeks after operation ： Bone mass in the experimental side was significantly higher than that in the control side [（1.31±0.05,1.12±0.03）g, （P 〈 0.05）]. ② Comparison of osteogenetic time ： Comparison of osteogenetic time in the experimental side was significantly lower than that in the control side [（3.66±0.30,4.25±0.55） g, （P 〈 0.05）]. ③Examination of light microscope ： In the experimental side, besides a lot of newly born osteocyte, many normal structures of bone trabecula appeared at week 4. The structures of bone trabecula in the control side were less than that in the experimental side; Normal structure of osteocyte, even osteocyte and well-arranged bone trabecula appeared on the callus 6 weeks after operation in the experimental and control sides. ④ Examination resuits of electron microscope ： Much eollagenous fiber appeared in the tissue of callus in the experimental side and control side at week 2, normal osteogenic cells were found in the experimental side but not in the control side; mature osteocyte was seen in the experimental side at week 4, while the development of osteocyte seen in the control side was poor; there were normal osteocytes in the tissue of callus of the two sides 6 weeks later, CONCLUSION： Osteogenetic ability after repair with autogenous bone dust mixed periosteous pieces is obviously strengthened compared with single bone dust. Operation of autogenous bone dust mixed periosteous pieces can improve bone quality, shorten osteogenetic time and promote the development of osteocyte with the advantages of simple method, easiness without wound, reliable effect, so as to provide a new method for repairing bone defect in clinic.
出处
《中国临床康复》
CSCD
北大核心
2005年第30期76-77,i0002,共3页
Chinese Journal of Clinical Rehabilitation
作者简介
张明，男，1962年生，河南省焦作市人，汉族，2000年广西医科大学毕业，硕士，副教授，副主任医师，主要从事骨与关节损伤的研究．Zhangming6210@sina．com
