新型纳米氮化钛银涂层髓内钉治疗家兔股骨骨折感染的研究

发布时间：2018-06-04 21:13

本文选题：骨折 + 内固定　；参考：《中国矫形外科杂志》2017年06期

【摘要】：[目的]观察研究纳米氮化钛银涂层髓内钉对家兔股骨骨折合并感染一期内固定的治疗效果。[方法]健康青年级家兔16只,随机分为纳米氮化钛组(Ti N)和纳米氮化钛银组(Ti N-Ag),建立家兔开放骨折合并金黄色葡萄球菌感染模型,一期应用Ti N髓内钉和Ti N-Ag髓内钉固定,对比观察两组家兔术后感染、日常活动、体重、体温等一般情况,定期拍摄X线片,术后8周取材进行微生物学和组织病理学检查,评价新型纳米氮化钛银涂层内固定材料的抗菌效果。[结果]术后8周,细菌培养结果提示Ti N组感染率为87.5%,Ti N-Ag组为25%(P=0.041);Ti N组动物体重平均增加(112.00±23.00)g,Ti N-Ag组增加(233.88±37.83)g,差异有统计学意义(P0.001);Ti NAg组体温明显低于Ti N组(P0.05)且波动较小;影像学检查结果:Ti N组骨折断端骨膜反应明显,有死骨形成,内固定松动移位,Ti N-Ag组骨折断段骨痂形成改建良好,内固定位置良好,未见明显死骨形成;组织病理学观察显示:Ti N组大量炎性细胞聚集浸润,Ti N-Ag组未见明显死骨及炎性细胞浸润。[结论]纳米氮化钛银涂层髓内钉对骨折合并感染有良好的预防和治疗效果,可有效降低术后感染风险。
[Abstract]:[objective] to observe the effect of titanium nitride silver coated intramedullary nail in the treatment of femoral fracture complicated with infection in rabbits. [methods] Sixteen healthy young rabbits were randomly divided into two groups: titanium nitride group (TiN) and silver nitride group (TiN-AgN). The open fracture model of rabbits with Staphylococcus aureus infection was established. The intramedullary nails and Ti N-Ag intramedullary nail were used in one stage. The infection, daily activity, body weight and body temperature of the two groups were observed. X-ray films were taken regularly. Microbiological and histopathological examinations were performed 8 weeks after operation. To evaluate the antibacterial effect of the new nano titanium nitride silver coating internal fixation material. [results] at 8 weeks after operation, the bacterial culture results showed that the infection rate of Ti N group was 87.5% and that of Ti N-Ag group was 25 N-Ag group. The average body weight increased by 112.00 卤23.00 g Ti N-Ag group. The difference was statistically significant (P 0.001Ti NAg group was significantly lower than that of Ti N group P0.05) and the fluctuation was small. The results of imaging examination showed that the periosteum reaction at the broken end of fracture was obvious and the dead bone was formed in the 0: tin group. The fracture callus formation and remodeling were good in the group of loose fixation and displacement of Ti N-Ag, the position of internal fixation was good, and no obvious dead bone formation was found. Histopathological observation showed that there were no obvious dead bone and inflammatory cell infiltration in the Ti N-Ag group. [conclusion] Nano titanium nitride silver coated intramedullary nail has a good effect on prevention and treatment of fracture complicated infection, and can effectively reduce the risk of postoperative infection.
【作者单位】：第四军医大学西京医院骨科;南方医科大学深圳医院骨科;北京华钽生物科技开发有限公司;
【基金】：西京医院学科助推计划(编号:XJZT14D01)
【分类号】：R687.33

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