带血供骨膜瓣复合去抗原异种松质骨修复兔桡骨骨缺损的实验研究

发布时间：2018-10-10 10:43

【摘要】：目的:探讨带血供骨膜瓣复合去抗原异种松质骨修复兔桡骨骨缺损的效能。方法:在60只新西兰大白兔双侧桡骨中段制造1.5 cm长骨缺损模型,其中30只动物一侧设为A组,骨缺损处植入去抗原异种松质骨后表面以带血供骨膜瓣覆盖;另一侧设为B组,骨缺损处单纯植入去抗原异种松质骨。剩余30只动物一侧设为C组,骨缺损处仅植入带血供骨膜瓣;另一侧设为D组,骨缺损处既不植入带血供骨膜瓣也不植入去抗原异种松质骨。A、B、C、D四组60只动物分别于术后4周,10周,16周各取20只动物进行正位X射线检查后空气栓塞处死,大体观察双侧骨缺损处组织变化情况,再以0.5 cm为样本长度取材,进行苏木精-伊红染色光镜观察与生物力学测试,根据Lane-Sandhu X射线评分标准与Lane-Sandhu骨移植组织学评分标准计算各组得分。A组均数分别与B、C、D三组均数比较,采用配对t检验,显著性水准设为0.05。结果:大体观察、X射线检查、HE染色光镜观察结果显示,术后4周,10周,16周在新骨的生成、结构塑形与去抗原异种松质骨降解方面A组均优于B组,根据Lane-Sandhu X射线评分标准与Lane-Sandhu骨移植组织学评分标准,A组评分高于B组(P0.05)。生物力学测试结果显示,术后4周,10周,16周A组最大负荷/位移比值高于B组(P0.05)。X射线检查结合大体观察结果显示C、D两组术后4周骨缺损处均被纤维组织填充,无新骨生成,两骨端吸收,术后10周骨缺损处均被大量瘢痕组织填充,仅少量骨痂生成,两骨端萎缩。术后16周骨缺损处均被瘢痕组织填充,两骨端锥形成骨,髓腔封闭,与尺骨融合,无骨性连接,均未行X射线评分与取材。结论:带血供骨膜瓣复合去抗原异种松质骨移植修复兔桡骨骨缺损能力强于单纯去抗原异种松质骨移植,新成骨具有较好的生物学结构与功能。
[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.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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