胶原膜引导下同种骨颗粒修复兔桡骨节段性缺损  

Reparation of rabbit radius segmental defects with allogeneic bone guided by degradable collagen membrane

作　　者：孙敬宇[1] 王志强[1] 宓士军[1] 韩凤梅[1] 周广军[1] 

机构地区：[1]唐山市丰润区人民医院骨科,河北省唐山市064000

出　　处：《中国组织工程研究与临床康复》2009年第12期2211-2216,共6页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：胶原膜是一种可吸收引导成骨材料，同种异体骨是较为理想的骨替代材料，但单独应用均有其不足，拟将两种材料结合使用以期达到理想效果。目的：利用膜引导组织再生技术，观察胶原膜复合同种骨颗粒修复兔桡骨节段性骨缺损的成骨速度和质量，并与单纯胶原膜进行比较。设计、时间及地点：同体对照观察实验，于2004—09／2005-02在中国辐射防护研究院医用组织库中心实验室完成。材料：胶原膜规格20mm×20mm，由北京天新福医疗器材有限公司提供。同种异体骨颗粒按美国组织库标准制备，直径0．2-0．7mm，由山西省医用组织库提供。方法：健康成年新西兰大白兔40只，制备双侧15mm桡骨缺损模型，采用同体对照方法，实验侧（左侧）缺损区移植胶原膜及同种骨粒，对照侧（右侧）仅移植胶原膜。主要观察指标：光镜组织学观察骨缺损愈合情况，计算机图像分析仪计算骨小梁的成骨面积，扫描电镜观察缺损再生修复情况。结果：①光镜组织学变化：实验侧新骨增生明显，迅速，以膜性化骨及软骨内化骨的方式由骨缺损周围向中央成骨或以同种骨粒为中心由周围向骨粒内成骨，最后骨膜形成，新髓腔不断扩大、再通，骨重建顺利，缺损修复完成。对照侧成骨方式以软骨化骨为主，新骨形成较同期实验侧慢，新骨成熟度不如实验组。②成骨面积图像分析：结果显示术后2，4，8周新生骨小梁成骨面积均大于同期对照侧（P〈0．05）。③扫描电镜观察：术后8周实验侧有较多分泌胶原的成骨细胞和带有较多突起的骨细胞，钙盐沉积，骨质排列开始有序。对照侧软骨与类骨质互相存在，低倍下骨基质排列无序，胶原纤维编织样排列。术后12周实验侧骨质排列有序，胶原粗大排列整齐，大量骨细胞方向有序，大量钙盐沉积，可见哈佛氏管�BACKGROUND： The collagen membrane is a kind of osteoinductive material, while allogeneic bone is an ideal bone substitute. OBJECTIVE：Whether the combination of the two materials can achieve a better effect need to be explored. Using membrane guided tissue regeneration technique, to observe the healing velocity and quality of repairing rabbit radius segmental defect combined collagen membrane with allogeneic bone, further more, to contrast the result with pure collagen membrane. DESIGN,TIME AND SETTING：The homebody control experiment was performed at the Central Laboratory of Medical Tissue Bank of Shanxi Province, China Institute for Radiation Protection from September 2004 to February 2005. MATERIALS：The collagen membrane with size of 20 mm ×20 mm was supplied by Tian Xin Fu Medical Appliances Co., Ltd. AIIogeneic bone with diameter of 0.2-0.7 mm was obtained from Shanxi Medical Tissue Bank. METHODS：A total of 40 New Zealand rabbits were created standard model of 15 mm defect in double radii. Using homebody control method, combined collagen membrane with allogeneic bone and collagen membrane was transplanted to the left and right side to cure bone defect, respectively. MAIN OUTCOME MEASURES： Bone defect healing was examined by histological observation. Osteogenic area was calculated by image analysis, and regeneration and repair of bone defects were analyzed by scanning electronic microscope （SEM）.RESULTS （1）Histological changes： bone formation grew quickly with osteoblast mode of membranous ossification and cartilaginous ossification or from periphery to center of bone particle, which lead to periosteum formed, and the bone defect was repaired. Osteoblast mode of the control group was mainly os cartilaginea, which was lower in osteocytes mature than the experimental group. （2）Image analysis showed that forming area of new bone was greater in experimental group than the control group at 2, 4, and 8 weeks after surgery （P 〈 0.05）. （3）SEM observation： At 8 weeks after s

关 键 词：引导性骨再生 胶原膜 同种骨粒 骨诱导 骨传导 骨形态发生蛋白 骨缺损 

分 类 号：R318[医药卫生—生物医学工程]