聚乳酸捆绑带与钢丝固定对骨折端血液循环重建影响的对比研究  

Effect of the self-locking cerclage band made of poly-DL-lactic acid fixation on reconstruction of blood circulation at the fracture

作　　者：李开南[1] 陈太勇[1] 兰海[1] 

机构地区：[1]成都大学附属医院骨科,四川成都610081

出　　处：《四川医学》2011年第5期649-652,共4页Sichuan Medical Journal

摘　　要：目的研究聚-DL-乳酸(poly-DL-lactic ac id,PDLLA)自锁式捆绑带固定与钢丝固定非负重骨折块后,骨折端血液循环重建即血管内皮生长因子(VEGF)表达情况,以探讨聚-DL-乳酸自锁式捆绑带固定与钢丝固定对骨折端血液循环的影响。方法 80只新西兰大白兔随机分为两组,建立股骨干非负重骨折动物模型,应用生物降解自锁式捆绑带固定骨折块为实验组,钢丝固定骨折块为对照组,分别于术后2周、4周、8周、12周用免疫组化及免疫印迹(W estern B lot)方法检测VEGF和CD34表达。结果术后2周时,实验组血管内皮细胞、成纤维细胞、成骨细胞、软骨细胞中血管内皮生长因子(VEGF)表达强于对照组(P<0.05),术后4周、8周、12周实验组和对照组血管内皮生长因子(VEGF)表达无明显差别(P>0.05);免疫组化两组均见大量强阳性染色的细胞,第2周时,捆绑带组骨组织免疫组化平均光密度值和微血管密度较钢丝组明显增加(P<0.05);4周、8周、12周时,实验组和对照组骨组织免疫组化平均光密度值和微血管密度差异无统计学意义(P>0.05)。结论聚-DL-乳酸自锁式捆绑带固定比钢丝捆绑带固定有利于骨折端血液循环重建。Objective To study the effect of self-locking cerclage band made of poly-DL-lactic acid in the fixation on bone healing and expression of Vascular endothelial growth factor（VEGF）.Methods 56 rabbits were randomly divided into two groups.Femur fractures of the none weight-bearing models were made.Fractures were fixed using self-locking cerclage band made of poly-DL-lactic acid in experimental group and metal fixation material in control group.The expression of VEGF and CD34 after 2,4,8,12weeks were detected by the immunohistochemistry and Western blot.Results The levels of VEGF protein in the experimental group were higher in vascular endothelial cells,fibroblasts,osteoblasts,cartilage cells than those in the control group at 2 weeks after fracture（P0.05）.The levels of VEGF protein were no difference between two groups at 4,8,12 weeks after fracture（P0.05）.A large number of strong positive staining of cells was detected by the immunohistochemistry in experimental group and control group.But mean optical density value and microvessel density were significantly increased in experimental group at 2 weeks（P0.05）.While mean optical density value and microvessel density were no difference between two groups at 4,8,12 weeks after fracture（P0.05）.Conclusion There were better effect on reconstruction of blood circulation at the fracture and fracture healing with self-locking cerclage band made of poly-DL-lactic acid fixed.

关 键 词：聚-DL-乳酸 捆绑带 钢丝 VEGF 微血管密度 骨折 

分 类 号：R687.3[医药卫生—骨科学]