兔创伤性股骨颈骨折后股骨头血流的改变及其意义  

The change of femoral head blood flow in traumatic femoral neck fracture in rabbit

作　　者：于腾波[1] 王叙馥[1] 褚言琛[1] 兰秀夫[2] 王爱民[2] 

机构地区：[1]青岛大学医学院附属医院创伤骨科,266003 [2]第三军医大学附属大坪医院骨科,重庆

出　　处：《中华创伤杂志》2007年第2期100-103,共4页Chinese Journal of Trauma

基　　金：山东省自然科学基金资助项目（Q2001C01）

摘　　要：目的采用三相^99Tcm-亚甲基二磷酸盐（MDP）骨显像评价创伤性股骨颈骨折后各时期股骨头血流灌注的变化。方法24只左侧股骨颈骨折的新西兰大白兔，分别与骨折前、骨折后即刻、1，3个月行三相骨显像，评价股骨头血流改变，计算左右两侧放射性计数比（头-头比）。结果骨折前双侧股骨头血流分布对称，左右头头比为1．01±0．04，骨折后即刻、1，3个月左侧股骨头血流灌注表现为正常、低血供、高血供倾向，静态相左右头-头比分别为1．08±0．36，0．83±0．26，3．68±0．21。结论创伤性股骨颈骨折后即刻，供应股骨头血流的血管可能并未受到损伤，早期或后期的继发性因素致使血管损伤、股骨头的血供和代谢受到影响；骨折造成血管直接损伤机制可能并非创伤性股骨颈骨折后股骨头坏死的主要原因，可能还存在其他的多种机制。Objective To evaluate the changes of femoral head blood flow after traumatic femoral neck fracture in each period with ^99Tcm-methylenediphosphonates（^99Tcm-MDP） three dimensional images. Methods Twenty - four rabbits were examined by three dimensional images before and instantly after the left femoral neck fracture as well as at 1 and 3 months after the fracture to evaluate the dysfunction of femoral head blood flow. The uptake ratio of bilateral femoral head was calculated in static phase. Results The femoral head blood flow of the right and left sides was symmetry with the normal uptake ratio （1.01 ±0.04） before fracture. The tendency of normal, low and high blood flows was observed using three dimensional images immediately and at 1 and 3 months after fracture, and at the same time, the uptake ratio of the right and left femoral head blood flows was 1.08 ± 0.36,0.83 ± 0.26, 3.68 ± 0.21, respectively in static phase. Conclusion After traumatic femoral neck fracture , the immediate femoral head blood flow is not possibly affected by the fracture. The secondary factors in early or late period result in blood vessel injury, thus affecting the femoral head blood flow and metabolism. Perhaps the major direct reason of femoral head necrosis after traumatic femoral neck fracture is not the mechanism of blood vessel injury resulting from fracture. There might be other mechanisms.

关 键 词：股骨颈骨折 股骨头坏死 血液循环 

分 类 号：R686[医药卫生—骨科学]