带血管蒂骨膜瓣移植治疗幼犬股骨头坏死实验研究  

An experiment study of the vascular pedicled periosteum transfer for the treatment of femoral head necrosis in young dogs

作　　者：官建中[1] 周建生[1] 肖玉周[1] 刘振华[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院骨科组织移植安徽省重点实验室,233004

出　　处：《中华显微外科杂志》2010年第3期217-220,I0007,共5页Chinese Journal of Microsurgery

基　　金：安徽省教育厅自然科学研究计划项目（2004kj275）

摘　　要：目的评价幼犬带血管蒂骨膜成骨能力及对股骨头无菌性坏死的修复效果。方法结扎、破坏幼龄家犬股骨颈动脉环、液氮冷冻股骨头，建立股骨头坏死动物模型。建模4周后通过X线、MRI、ECT及组织学检查评价动物模型建立成功与否；然后实验动物随机分成3组，实验组（12只）植入带旋股外侧动脉横支为蒂大转子骨膜瓣；对照组（9只）植入带旋股外侧动脉横支为蒂大转子骨瓣；空白组（8只）不予治疗，以观察股骨头坏死的病程进展。分别于手术后第4、8、12周进行大体形态、X线、MRI、ECT观测，12周处死所有动物行组织学检查，观察不同时期股骨头坏死修复情况。结果术后12周实验组X线股骨头形态基本正常，MRI股骨头信号不均，ECT放射性核素与健侧相比稍减低，苏木精-伊红（HE）染色毛细血管及成骨细胞大量增殖，新生骨小梁成熟。对照组X线股骨头轮廓欠规则，MRI股骨头高低信号混杂，ECT股骨头放射性核素明显减低，HE染色成骨细胞活跃，可见新生骨小梁，脂肪细胞。空白组X线股骨头塌陷变形，MRI表现T1、T2加权低信号，ECT见放射性缺损，苏木精-伊红染色骨小梁崩解，大量空虚的骨陷窝。术后12周实验组、对照组移植骨膜／骨瓣区ECT扫描核素计数差异有统计学意义（P〈0．01）。结论带血管蒂骨膜移植较带血管蒂骨瓣移植具有更强的成骨能力，能够有效地修复幼犬股骨头无菌性坏死。Objective To explore an effective method for establishing femoral head necrosis models in young dog and to evaluate osteogenesis of vascular pedicled periosteum transplanted in the repairment offemoral head necrosis of young dogs. Methods Animal models of femoral head necrosis were established by ligating and destroying femoral neck artery circles as well as freezing femoral heads with liquid nitrogen in 29 dogs. At 4 weeks, the animal models of femoral head necrosis were evaluated through X-ray, MRI, ECT, and 2 dogs were randomly executed and detectd by histology examination, then 29 dogs were divided randomly into experimental group （n = 12）, control group （n = 9 ）and blank group （n = 8）. Dogs in the experimental group were treated with the vascular pedicled periosteum from isolateral great trochanter, dogs in the control group were treated with the vascular pedicled bone from isolateral great trochanter, and the blank group were without any treatment. 4,8,12 weeks postoperation, these femoral heads were examined morphologically, radiologieally （X-ray, MRI, ECT） and histologically. All animals were executed and detectd by histol- ogy at 12 weeks to observe the repairs of necrotic femoral heads at different periods. Results Twelve weeks postoperation, dogs femoral head figurations in the experimental group were normal, MRI signals were odds in femoral head, ECT studies shows decreased radionuclide compared with contralateral femoral head; capillary vessel and osteoblast multiplication and new trabeculacs were matured in histology examination. Dogs femoral head figurations in the contral group were irregular, MRI revealed high-low signals intermix in femoral head, ECT revealed obviously decreased radionuclide, osteoblast actived , new trabeculac and lipocyte were observed in histology examination. In blank group, femoral head figurations were distorted and sunk, while MRI signals were low, ECT showed no radionuclide uptaking. Collapsed trabecnlas and many vacant bone lacuna were observed in HE sta

关 键 词：股骨头坏死 带蒂骨膜瓣 移植 显微外科 幼犬 

分 类 号：R687.3[医药卫生—骨科学]