开放骨缺损海水浸泡感染后人工材料修复的对比研究  

Repair for infectious open fracture after seawater immersion with artificial material

作　　者：刘敏[1] 朱庆生[1] 洪建明[2] 胡学峰[2] 

机构地区：[1]解放军第四军医大学研究生院,陕西西安710032 [2]南京军区庐山疗养院骨科,江西九江332000

出　　处：《东南国防医药》2011年第2期104-106,共3页Military Medical Journal of Southeast China

基　　金：南京军区医学科技创新项目(08Z018)

摘　　要：目的观察海水浸泡开放骨缺损感染后的人工材料修复组织病理及骨折骨痂生长影像学变化。方法取成年犬于桡骨中段截骨制成开放骨折并骨缺损2 cm动物模型,海水浸泡伤口2 h为实验组,对照组开放伤口自然暴露2h,伤口感染后分别取分泌物细菌培养及药物敏感试验,存在细菌感染共48只,其中实验组感染24只,对照组24只。实验组随机分成两组,给予行伤口清创,分别以纳米骨(纳米羟基磷灰石/聚酰胺66复合骨,Nano-hydroxyapatite/Polyamide 66)骨段植入及CPC(自固化磷酸钙calciumphosphate cement)凝固体植入,各12只;对照组随机分成两组,给予伤口清创后以纳米材料骨骨段及CPC凝固体植入,各12只。所有实验动物均以玻璃纤维石膏绷带固定,定期给予敏感抗生素肌内注射。术后2月观察各组动物骨缺损骨折端的组织病理学及影像学变化。结果①实验组与对照组以及纳米骨与CPC间组织病理结果有统计学差异(P<0.05);②术后12周实验组与对照组间以及纳米骨与CPC间断端骨痂组织愈合等级有统计学差异(P<0.01)。结论海水浸泡开放骨缺损感染后人工材料修复比自然暴露骨缺损修复效果差;开放骨缺损感染后CPC凝固体植入较纳米骨骨段植入修复效果好。Objective To explore the alterations on pathology and fracture callus growth imaging when using artificial material to repair for the open fracture with infection after seawater immersion.Methods Osteotomy was conducted in the middle part of ulna on an adult dogs,and 2 centimeters animal model of open fractures and bone defect were made.The test group was immersed in seawater and the control group was exposed in the air for two hours.Secretion from infected wound was taken for germiculture and drug susceptibility testing.48 dogs were bacterial infection,including 24 dogs in control group.The test group was divided into two subgroups randomly.Wound debridement was carried out.12 dogs were given nanomaterials bone and 12 dogs were implanted with calcium phosphate cement（CPC） solidified body respectively.The control group was carried out same as test group.All the experimental animals are fixed by using the glass fiber plaster bandage,and then were given sensitive antibiotics muscle injections regularly.The histopathological and imaging changes of animal bone defect fracture were observed for 12 weeks.Results There was a significant difference in pathological examination between the test and control group（P〈0.05）.A significant difference of repair degree was observed between the nanomaterials bone and CPC solidified body implants（P〈0.01）.Conclusion The effect of artificial material repair for the open fracture with infection after seawater immersion is inferior to that of exposed to air.Hoever,the effect of CPC solidified body implants is superior to that of the nanomaterials bone.

关 键 词：开放性骨缺损 海水浸泡 人工骨 感染 

分 类 号：R318.17[医药卫生—生物医学工程]