微创植骨术与开放植骨术治疗骨缺损的对比研究  

Comparison of treatment effect of bone defect with minimally invasive surgery and open bone grafting

作　　者：臧危平[1] 董英海[1] 李展春[1] 信维伟[1] 

机构地区：[1]上海第二医科大学附属仁济医院骨科,上海200127

出　　处：《临床骨科杂志》2006年第1期65-68,共4页Journal of Clinical Orthopaedics

摘　　要：目的观察微创植骨术治疗骨缺损的疗效。方法建立兔双侧桡骨干骨缺损模型。将每只动物双侧前肢随机分入开放植骨术组(A组)和微创植骨术组(B组)。B组用自行研制的微创植骨器进行微创植骨。术后不同时间对骨缺损部位进行双能X线骨密度检查、光镜观察和电镜观察。结果术后不同时间两组骨缺损部位的骨密度随时间延长逐渐增高,但同一时间B组的骨密度均高于A组,两组差异有显著性(P<0.01);光镜观察B组骨小梁形成速度快于A组,骨小梁向板层骨塑形时间亦早于A组;电镜观察B组成纤维细胞和成骨细胞出现时间、两种细胞内细胞器活跃程度、细胞周围胶原纤维及钙盐的沉积数量均优于A组,新生骨塑形速度亦快于A组。结论用微创植骨器治疗骨缺损,在减小手术创伤的同时可加快骨缺损的修复速度,提高骨缺损的修复质量。Objective To study the treatment effect of minimally invasive bone grafting on bone defects. Methods Bone defect model was established in bilateral shaft of radius in 30 rabbits. All cases were randomized into open grafting group （Group A ）and minimally invasive grafting group（ Group B ）. Group B was performed minimally invasive grafting with self-made instruments. DEXA , histology and electron microscopy were investigated in radial bone defect after 6 rabbits were sacrificed randomly at different time after bone grafting. Results DEXA showed bone density increased gradually in both groups. The bone density in Group B was higher than that in Group A with significant difference （P 〈0. 01 ）at each period; Histological examination showed faster trabecular formation and remodeling in Group B; Electron microscopy showed that fibroblast and osteoblast occurred earlier in bone defect with more active organelle morphology, more collagen and calcium deposition and faster new bone remodeling in Group B. Conclusions Minimally invasive bone grafting can accelerate and improve bone defect repair with the minimally invasive instruments.

关 键 词：植骨术 微创 骨缺损 

分 类 号：R687.34[医药卫生—骨科学]