闭合性胫骨骨折骨膜微血管功能的动力学研究  

The dynamical investigation on the function of microcirculation of tibial periosteum after closed fracture

作　　者：张俐 ThomasMittlemeier N.P.Haas Klaus-DSchaser 

机构地区：[1]洪堡大学Charite,Campus,Virchow,创伤与重建外科

出　　处：《中国骨伤》2003年第8期449-451,共4页China Journal of Orthopaedics and Traumatology

基　　金：德国国家自然科学基金资助项目(Deutsche Forschungs gemeinschaft Scha 930/1-1 & 1-2)

摘　　要：目的 通过建立闭合性胫骨骨折的动物模型,在荧光显微镜下动态观察骨折后骨膜微循环的动力学改变。方法 Sprague-Dawlay大鼠14只,随机分为对照组和骨折组。使用改良快速冲击法造成大鼠左下肢胫骨中段标准的横行骨折,显微手术解剖胫骨,充分暴露骨膜,在显微镜及计算机图像分析软件下进行骨膜微血管的动力学研究。结果 闭合性胫骨骨折导致骨膜功能性毛细血管密度、毛细血管网微动、静脉内红细胞移动速率及毛细血管回流量下降(P<0.05);此外,亦引起毛细血管网动、静脉的管径扩大,毛细血管网动、静脉渗透率增加,毛细血管白细胞及内皮细胞的交互作用增强(P<0.01)。结论 骨折导致骨膜微血管损伤,而骨膜微血管损伤的程度又直接影响甚至决定骨折的愈合。如何修复与重建骨折后骨膜微循环是治疗骨折的又一关键。Objective Passsing through the establishment of animal model imitated from the closed tibial fracture under the fluorescent microscopy to observe the dynamical changes of microcirculation of periosteum after bone fracture Methods 14 Sprage-Dawley rats were divided randomly into bone fractured and control group,7 rats for each group. The standardized transversal bone fracture of middle part of left tibial shift was induced with modified rapid weight drop technique. The periosteum of tibia was exposed fully with micro-surgical anatomy. The dynamical investigation had been carried out under microscopy and the software of computer, associated with image analysis system. Results The closed tibial fracture could decrease the functional density of periosteum, the velocity of the movement of erythrocytes,intra-micro-arteries and veins and the amount of reflux of capillaries (P < 0.05). In addition, It could also increase the calibers and osmotic rate of arteries and veins in the capillaries net,and enstrengthen the interaction of white blood cells and endothelial cell in the capillaries (P<0.01). Conclusion Bone fracture can induce the damage of microcirculation of periosteum,and the grade of damages of micro-circulation can also directly influence or even determine the healing of bone fracture. The another key problem of treating the bone fracture might be how to recover and reestablish the micro-circulation of periosteum.

关 键 词：胫骨 骨折 闭合性 骨膜 微循环 血液动力学 

分 类 号：R68[医药卫生—骨科学]