Gel-HA-M复合材料联合钛网固定修复兔股骨缺损效果观察

发布时间：2018-01-24 18:24

本文关键词： 骨缺损股骨明胶羟基磷灰石米诺环素钛网兔　出处：《山东医药》2017年32期 　论文类型：期刊论文

【摘要】：目的探讨明胶-羟基磷灰石-米诺环素(Gel-HA-M)复合材料联合钛网固定对兔股骨缺损的修复作用。方法将30只雄性新西兰大白兔随机分为复合材料组、自体骨对照组及空白对照组,每组10只。三组均建立股骨缺损模型(缺损长度12~15 mm),复合材料组植入Gel-HA-M复合材料联合钛网固定,自体骨对照组植入自体股骨联合钛网固定,空白对照组仅行钛网固定。三组分别于术后4、8、12周随机选取3、3、4只兔,处死后取出股骨行大体观察、X线检查,HE染色后观察组织病理情况。结果术后4周:复合材料组植入材料与周围骨组织界限稍模糊,X线检查显示钛网周围无明显骨痂形成,HE染色可见片状、条索状、网状软骨样基质形成;自体骨对照组可见自体骨与断端部分愈合,X线检查显示钛网周围无明显骨痂形成,HE染色可见大量网状编织骨形成;空白对照组有2只存在感染迹象,X线检查显示钛网周围无明显骨痂形成,HE染色未见连续性骨样基质形成。术后8周:复合材料组植入材料的硬度与周围骨组织接近,X线检查显示钛网周围骨痂逐渐增多,HE染色可见新生骨组织明显增多,形成网状致密的骨小梁组织;自体骨对照组骨缺损处基本愈合,X线检查显示钛网周围骨痂逐渐增多,HE染色可见新生骨组织进一步成熟,骨组织钙化较之前增强;空白对照组未形成骨性愈合,X线检查显示钛网周围无明显骨痂形成,HE染色未见连续性骨样基质形成。术后12周:复合材料组骨缺损区已达到骨性愈合,X线检查显示钛网周围大量骨痂形成、两断端连接,HE染色可见新生骨组织逐渐成熟,伴髓腔形成;自体骨对照组骨缺损区基本达到骨性愈合,X线检查显示钛网周围大量骨痂形成、两断端连接,HE染色可见编织样骨组织趋于有序性排列;空白对照组断端仍未形成骨性连接,X线检查显示钛网周围少量骨痂形成,HE染色未见连续性骨样基质形成,伴有纤维结缔组织及炎性细胞大量增生。结论 Gel-HA-M复合材料联合钛网固定对兔股骨缺损的修复效果与自体骨的修复效果相当,并有助于减少感染发生,是一种效果较好的人工合成骨缺损修复材料。
[Abstract]:Objective to study Gel-HA-M of gelatin, hydroxyapatite and minocycline. Methods 30 male New Zealand white rabbits were randomly divided into composite group and composite group. The femur defect model was established in each group with 10 rats in the autogenous bone control group and 10 in the blank control group (the length of the defect was 1215 mm). Gel-HA-M composite material combined with titanium mesh fixation was implanted in the composite group, autogenous femur combined with titanium mesh fixation was implanted in the autologous bone control group, and titanium mesh fixation was only performed in the blank control group. After 12 weeks, 3 rabbits were randomly selected and the femur was taken out for gross observation and X-ray examination. Results at 4 weeks after HE staining, the boundary between the implanted material and the surrounding bone tissue in the composite group was slightly blurred and X-ray examination showed that there was no obvious callus formation around the titanium mesh. Strip, reticular chondroid matrix formation; X-ray examination showed that there was no obvious callus formation around the titanium mesh in the autologous bone control group and a large number of reticular braided bones were found in HE staining. In the blank control group, there were 2 cases of infection. X-ray examination showed that there was no obvious callus formation around the titanium mesh. There was no continuous bone like matrix formation in HE staining. 8 weeks after operation, the hardness of the composite material was close to that of the surrounding bone tissue. X-ray examination showed that the callus around the titanium mesh increased gradually. He staining showed that the number of new bone tissue was obviously increased, and the meshwork was formed in the form of dense bone trabeculae. X-ray examination of bone defect in autogenous bone control group showed that the callus around titanium mesh increased gradually. He staining showed that the new bone tissue matured further and the calcification of bone tissue was enhanced. X-ray examination showed that there was no obvious callus formation around titanium mesh and no continuous bone like matrix formation was observed in the blank control group. 12 weeks after operation, bone healing was achieved in the bone defect area of the composite group. X-ray examination showed that a large number of callus formed around the titanium mesh, and HE staining showed that the new bone tissue matured and the medullary cavity formed. X-ray examination showed that a large number of callus formed around the titanium mesh, and HE staining of the two broken ends showed that the braided bone tissue tended to be arranged orderly. X-ray examination showed that a small amount of callus formed around the titanium mesh and no continuous bone like matrix was formed by HE staining in the blank control group. Conclusion the effect of Gel-HA-M composite combined with titanium mesh fixation on repairing femoral defect in rabbits is similar to that of autogenous bone. It is helpful to reduce the incidence of infection and is a good synthetic bone defect repair material.
【作者单位】：安徽医科大学第一附属医院;安徽医科大学附属口腔医院;安徽医科大学第二附属医院;
【基金】：安徽省科技攻关计划项目(1301042096)
【分类号】：R687.3
【正文快照】： 3安徽医科大学第二附属医院)近年来因创伤骨折、感染和骨肿瘤等引起的骨缺损患者日益增多,而较大的骨缺损常常无法自我修复[1]。临床上常用自体骨移植或者用同种异体骨和动物源性的异种骨移植来修复骨缺损,但自体骨移植取材量有限且存在二次伤害[2,3],同种异体骨和动物源性的

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