以带蒂筋膜瓣为膜材料应用GBR技术修复兔骨缺损的血管化作用及成骨方式研究  

The study about the vascularization and the osteogenesis in the process of rabbit bone defect repair using the pedicle fascial flap as the membrane material and the GBR technique

作　　者：孟宪勇[1] 杨新明[1] 彭阿钦[2] 王耀一[1] 齐志民[1] 白瑞[1] 

机构地区：[1]河北北方学院附属第一医院,河北张家口075000 [2]河北医科大学第三医院创伤骨科,河北石家庄050031

出　　处：《生物骨科材料与临床研究》2010年第5期10-15,共6页Orthopaedic Biomechanics Materials and Clinical Study

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;医学科学研究重点课题(09276102D-46);河北北方学院2009年校级科研(2009037)

摘　　要：目的研究带蒂筋膜瓣作为膜材料应用于膜引导性骨再生技术修复骨缺损的过程中血管化进程及成骨效果方法24只5月龄新西兰大白兔雌雄不限,制备双侧尺骨1cm骨缺损模型,自体红骨髓(au-tologous red bone marrow,ARBM)接种于骨诱导活性材料(Osteoinductive absorbing material,OAM)制备组织工程骨。将非细胞型组织工程复合物植入骨缺损区,右侧单纯可吸收生物膜包裹设为A组,左侧带血运深筋膜瓣包裹设为B组。各组在4、8、12、16周后进行X线检查、光密度比值测量、大体观察和组织学检查、交界区血管图像计量分析,将数据作统计学处理,用以比较骨缺损修复情况。结果X线片、大体形态和组织学观察显示,植入物内部血管的长入、骨小梁及软骨组织形成的数量和速度、成熟骨结构的形成、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解,筋膜瓣组均明显优于生物膜组。光密度比值测量显示,术后8、12、16周两组间比较及同组内各时间点间比较差异均有统计学意义(P<0.05),术后4、8、12、16周,骨修复交界区单位面积内血管再生面积筋膜瓣组明显多于生物膜组,差异有统计学意义(P<0.05)。从术后12周,筋膜瓣组随着成熟骨结构形成,血管结构减少或消失。结论带血运筋膜瓣具有明显的促组织工程骨血管化作用并通过促血管化而促进成骨并具备膜引导性骨再生(guided bone regeneration,GBR)技术的骨修复特点,即早期促进外骨痂生长。Objective To study the vascularization and the osteogenesis in the process of the bone defect repair using the pedical fascial flap with vessels as the membrane material and the guided bone regeneration technique.Methods 24 Newzland 5-month-old rabbits,male or female,were usd to prepare the hibateral periosteum-included bone defect models in the middle piece of the ulna and the length of the defect was 1cm.Autologous red bone marrow was implanted in the osteoinductive absorbing material to prepare tissue engineering bone.Implanted the prepared uncellular tissue engineering compound in the bone defect area and the right defects wrapped by the simple absorbable biomembrane were allocated to Group A while the left defects wrapped by pedical fascial flap with blood supply were allocated to Group B.At the fourth,eighth,twelfth and sixteenth week after the operation each group was examined by the radiograph（x-ray）,the light density measurement,gross morphology and histological inspection,bone shape measurement analysis in the junctional zone.The data was analyzed by statistics to see the difference of the bone defect repair.Results In the aspects of the the radiograph,gross morphology and histological inspection,the growth of the vessels in the implant,the quantity and the forming speed of the bone trabecula and the cartilaginous tissue,the formation of the mature bone structure,remodeling of the diaphysis,recanalization of the cavum ossis and the absorp-tion and the degradation of the implant the group of pedical fascial flap with blood supply was superior to the group of the simple absorbable biomembrane.By the comparision of the the light density measurement the difference between the two groups at the eighth,twelfth and sixteenth week after the operation and the difference of the same group at each time point all had statistical significance（P0.05）.At the fourth,eighth,twelfth and sixteenth week after the operation the regenerated vessel area of the unit area in the junctional zone of bone recovery could be

关 键 词：骨缺损 带蒂筋膜瓣 膜引导组织再生 自体红骨髓 血管化组织工程骨 

分 类 号：R687.3[医药卫生—骨科学]