以带蒂筋膜瓣包裹复合自体红骨髓构建非细胞型组织工程化骨修复兔桡骨缺损  

Repairing rabbit's radial bone defect by using uncellular tissue engineered complex constructed by autologous red bone marrow wrapped by facial flap with vessels

作　　者：杨新明[1] 石蔚[1] 杜雅坤[2] 孟宪勇[1] 阴彦林[1] 李化光[1] 

机构地区：[1]河北北方学院附属第一医院,河北省张家口市075000 [2]河北省儿童医院,河北省石家庄市050031

出　　处：《中国组织工程研究与临床康复》2009年第46期9050-9054,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：河北省科技厅2009年度河北省科学技术研究与发展计划;医学科学研究重点(09276102D-46);河北省张家口市2008年科学技术与发展指令计划(0801045D-10)~~

摘　　要：背景:国外学者将红骨髓和生成因子复合即时植入用于促进骨折愈合已经获得满意效果。由于不需体外培养过程,只要在抽取红骨髓后与支架生成因子复合并立即植入,被称为"非细胞型组织工程化骨"。目的:课题创新性提出以带蒂筋膜瓣包裹复合自体红骨髓方法构造非细胞型组织工程化骨修复骨缺损,并验证其优势性。设计、时间及地点:同体对照动物实验,于2007-12/2009-02在河北北方学院及附属医院实验中心完成。材料:四五月龄新西兰大白兔24只;取自体红骨髓与含骨形态发生蛋白的骨诱导活性材料混合成非细胞型组织工程骨。方法:将成年新西兰大白兔双侧桡骨造骨缺损模型,左侧为对照组,仅植入骨诱导活性材料复合物,右侧为带蒂筋膜瓣实验组,利用显微外科技术在骨缺损邻近制备一个带有无名血管蒂所属毛细血管网的筋膜瓣,使其包裹非细胞型组织工程骨并充填骨缺损。主要观察指标:于术后4,8,12,16周各取6只兔,进行X射线检查和吸光度比测量、大体观察和组织学检查、修复区内骨形态计量分析和交界区血管图像分析。结果:①X射线检查:16周,对照组骨缺损周边植入物初步形成骨干结构,骨皮质不连续,髓腔不通;实验组正常骨干结构形成,骨髓腔完全再通。②组织学观察:16周,对照组植入物内血管长入较少和发育较成熟的骨小梁,骨髓腔未通;实验组植入物已吸收降解,完全由新骨替代,成熟骨结构形成,骨髓腔再通。③修复区内骨形态计量分析:术后4,8,12,16周实验组的骨小梁的体积明显多于对照组(P<0.05)。④交界区血管图像分析:实验组各时间段单位面积内血管再生面积均大于对照组(P<0.05)。结论:带蒂筋膜瓣包裹复合自体红骨髓构建非细胞型组织工程化骨,具有膜诱导骨再生和血管化双重作用,对修复大段骨缺损是可行的,在缩短骨缺损修复时间,提高成骨的BACKGROUND： Foreign scholars have obtained a success to cure fracture by implanting the complex of red bone marrow and formation factor. Due to the in vitro culture process is not necessary, the complex of red bona marrow and scaffold formation factor is only required to be implant immediately, called uncellular tissue engineered bone. OBJECTIVE： This study innovatively constructs uncellular tissue engineered bone with autologous red bone marrow wrapped by fascial flap with pedicle, and validates the superiority of repairing bone defects. DESIGN, TIME AND SETTING： Homebody controlled animal experiment was performed in the Hebei North University and the Experiment Center of the Affiliated Hospital to Hebei North University from December 2007 to February 2009. MATERIALS： A total of 24 News Zealand albino rabbits, aged 4-5 months; uncellular tissue engineered bone was a mixture of autologous red bone marrow and osteoinductive absorbing materials containing bone morphogenetic proteins. METHODS： Bone defect models were induced on adult New Zealand rabbits＇ right radial bone, left side served as control group, only implanted with osteoinductive absorbing materials complex, while right side served as experiment group, which contained fascial flap with pedicle. A fascial flap prepared with capillary network containing nameless blood vessel pedicle was located to be adjacent to the bone defect using micro-surgical technique, to wrap the tissue engineered bone and to fill the bone defect. MAIN OUTCOME MEASURES： At 4, 8, 12, 16 weeks postoperation, six rabbits were tested by radiograph, spectrodensitometry, gross morphology observation, histological inspection, quantitative analysis of bone morphometry in bone defect area and analysis of vessels image in the junctional zone. RESULTS： ①X-ray determination： At 16 weeks, the implant surrounding bone defects formed bone shaft structure in the control group, cortical bone was not continuous and medullary cavity was obstructed; in the experiment group, normal

关 键 词：骨缺损 动物模型 带蒂筋膜瓣 膜诱导组织再生 自体红骨髓 骨形态发生蛋白 血管化 组织工程 骨移植 

分 类 号：R318[医药卫生—生物医学工程]