脑外伤对骨折愈合影响的相关因素研究
发布时间：2018-11-12 18:10
【摘要】：背景与目的:骨科临床实践中合并脑外伤的骨折病人,骨痂生长快、数量多,甚至部分病人出现异位骨化的现象,近来已有大量文献报道,对于该现象的探讨已成为骨科研究的热点。通过家兔脑外伤合并骨折及单纯骨折的动物模型,动态测定家兔血清中下丘脑-垂体-性腺轴的激素水平变化并对骨折断端病理切片的成骨细胞计数、直径,观察家兔脑外伤合并骨折愈合速度,通过数据分析,探讨对骨折愈合影响的相关因素。方法:选取家兔40只,随机分为2组,直线加速脑外伤合并尺骨骨折模型组(实验组),单纯标准尺骨骨折模型(对照组),每组各20只,两组分别于致伤前1天、3天、1周取血,再于致伤后1天、3天、1周及2周取血,用直接发光法测定血清中黄体生成素(LH)、辜丸酮(T)、雌二醇(E2)、催乳素(PRL)、生长激素(GH)、卵泡刺激素(FSH)水平;于致伤后1-6周,每周随机处死家兔子,每组各两只,通过病理组织学检查骨痂生长情况(观察成骨细胞的数量、直径的变化)。结果:1.血清激素测定结果在致伤后所有模型组(实验组和对照组)家兔检测血清激素均较伤前有明显升高,在伤后3天,所有激素水平达到峰值,1周时血清激素水平开始下降,伤后2周时,所有激素均回落至伤前测定激素水,实验组在致伤后激素水平均高于对照组。其中测定T、E2、GH激素水平在致伤后实验组较对照组明显升高,经统计学分析P0.05,有统计学意义,余PRL、FSH、LH虽实验组在致伤后均高于对照组,但经统学计分析P0.05,无统计学意义。2.患肢骨痂测定结果在致伤后1-6周,每周成骨细胞计数,实验组均高于对照组,经统计分析P0.05,有统计学意义,致伤后1到6周内,成骨细胞计数各组内对比,成骨细胞无递增性生长,经统计学分析P0.05,无统计学意义;成骨细胞直径测定,每周实验组与对照组比较无明显差异,经统计学分析P0.05,无统计学意义,组内对比,其测定值经统计学分析P0.05,无统计学意义。结论:本实验中,通过从血清激素水平及骨痂的病理学观察,其结果表明:在脑外伤合并骨折的愈合中,多种下丘脑垂体激素明显升高,并且参与了骨折愈合的这一过程,其分泌量的增高与骨折加速愈合相关。但在临床中还有骨折不愈合的患者,必定还存在多种可抑制骨折愈合的因子存在,以及未知的体液因素,还需有待于进一步研究、证实。
[Abstract]:Background & objective: in the clinical practice of orthopedics, the callus of fracture patients with brain trauma grows rapidly and has a large number of callus, and even some patients appear ectopic ossification phenomenon, which has been reported in a large number of literatures recently. The study of this phenomenon has become a hot spot in orthopedic research. The changes of hormone levels of hypothalamus-pituitary-gonadal axis in serum of rabbits were dynamically determined by the animal model of brain trauma complicated with fracture and simple fracture. The osteoblasts and diameters of pathological sections of broken end of fracture were counted. To observe the healing speed of brain injury complicated with fracture in rabbits, and to discuss the related factors of influencing fracture healing by data analysis. Methods: forty rabbits were randomly divided into two groups: the model group of linear accelerated brain injury combined with ulna fracture (experimental group) and the simple standard fracture of ulna model (control group) with 20 rabbits in each group. The two groups were divided into two groups: one day and three days before injury. 1 week blood was taken, and then blood was taken at 1 day, 3 days, 1 week and 2 weeks after injury. Serum luteinizing hormone (LH), Koo pill (T), estradiol (E2) and prolactin (PRL), growth hormone (GH), were determined by direct luminescence method. Follicle stimulating hormone (FSH) level; Rabbits were randomly killed at 1-6 weeks after injury with two rabbits in each group. The growth of callus was examined by histopathology (the number and diameter of osteoblasts were observed). The result is 1: 1. The levels of serum hormones in all the model groups (experimental group and control group) were significantly higher than those before injury. On the 3rd day after injury, the levels of all hormones reached the peak, and the serum hormone levels began to decrease at 1 week after injury. At 2 weeks after injury, all the hormones decreased to the levels of hormone water before injury, and the levels of hormones in the experimental group were higher than those in the control group. The level of GH in the experimental group was significantly higher than that in the control group after injury, and there was significant difference between the experimental group and the control group by statistical analysis (P 0.05). Although the level of PRL,FSH,LH in the experimental group was higher than that in the control group after injury, the level of GH in the experimental group was significantly higher than that in the control group. However, P0.05 was not statistically significant. The number of osteoblasts in the experimental group was higher than that in the control group at 1-6 weeks and every week after injury. There was significant difference in the number of osteoblasts between 1 and 6 weeks after injury by statistical analysis (P0.05), but within 1 to 6 weeks after injury, the number of osteoblasts in the experimental group was higher than that in the control group. Osteoblasts did not grow incrementally, and there was no statistical significance by statistical analysis (P0.05). There was no significant difference in the diameter of osteoblasts between the experimental group and the control group every week. There was no significant difference between the experimental group and the control group, but there was no significant difference between the experimental group and the control group. Conclusion: in this experiment, the serum hormone level and the pathological observation of callus showed that during the healing of traumatic brain injury with fracture, many kinds of hypothalamic pituitary hormones increased obviously, and participated in the process of fracture healing. The increase in secretion is associated with accelerated fracture healing. However, there must be many factors that can inhibit fracture healing and unknown humoral factors in the patients with nonunion, which need to be further studied and confirmed.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R683;R651.15
本文编号：2327823
[Abstract]:Background & objective: in the clinical practice of orthopedics, the callus of fracture patients with brain trauma grows rapidly and has a large number of callus, and even some patients appear ectopic ossification phenomenon, which has been reported in a large number of literatures recently. The study of this phenomenon has become a hot spot in orthopedic research. The changes of hormone levels of hypothalamus-pituitary-gonadal axis in serum of rabbits were dynamically determined by the animal model of brain trauma complicated with fracture and simple fracture. The osteoblasts and diameters of pathological sections of broken end of fracture were counted. To observe the healing speed of brain injury complicated with fracture in rabbits, and to discuss the related factors of influencing fracture healing by data analysis. Methods: forty rabbits were randomly divided into two groups: the model group of linear accelerated brain injury combined with ulna fracture (experimental group) and the simple standard fracture of ulna model (control group) with 20 rabbits in each group. The two groups were divided into two groups: one day and three days before injury. 1 week blood was taken, and then blood was taken at 1 day, 3 days, 1 week and 2 weeks after injury. Serum luteinizing hormone (LH), Koo pill (T), estradiol (E2) and prolactin (PRL), growth hormone (GH), were determined by direct luminescence method. Follicle stimulating hormone (FSH) level; Rabbits were randomly killed at 1-6 weeks after injury with two rabbits in each group. The growth of callus was examined by histopathology (the number and diameter of osteoblasts were observed). The result is 1: 1. The levels of serum hormones in all the model groups (experimental group and control group) were significantly higher than those before injury. On the 3rd day after injury, the levels of all hormones reached the peak, and the serum hormone levels began to decrease at 1 week after injury. At 2 weeks after injury, all the hormones decreased to the levels of hormone water before injury, and the levels of hormones in the experimental group were higher than those in the control group. The level of GH in the experimental group was significantly higher than that in the control group after injury, and there was significant difference between the experimental group and the control group by statistical analysis (P 0.05). Although the level of PRL,FSH,LH in the experimental group was higher than that in the control group after injury, the level of GH in the experimental group was significantly higher than that in the control group. However, P0.05 was not statistically significant. The number of osteoblasts in the experimental group was higher than that in the control group at 1-6 weeks and every week after injury. There was significant difference in the number of osteoblasts between 1 and 6 weeks after injury by statistical analysis (P0.05), but within 1 to 6 weeks after injury, the number of osteoblasts in the experimental group was higher than that in the control group. Osteoblasts did not grow incrementally, and there was no statistical significance by statistical analysis (P0.05). There was no significant difference in the diameter of osteoblasts between the experimental group and the control group every week. There was no significant difference between the experimental group and the control group, but there was no significant difference between the experimental group and the control group. Conclusion: in this experiment, the serum hormone level and the pathological observation of callus showed that during the healing of traumatic brain injury with fracture, many kinds of hypothalamic pituitary hormones increased obviously, and participated in the process of fracture healing. The increase in secretion is associated with accelerated fracture healing. However, there must be many factors that can inhibit fracture healing and unknown humoral factors in the patients with nonunion, which need to be further studied and confirmed.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R683;R651.15
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2 宋亚琪;张柳;骆阳;田发明;程潭;;卵巢切除股骨骨折大鼠骨愈合中降钙素的作用[J];中国组织工程研究与临床康复;2011年07期
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