以带蒂筋膜瓣为MGBR屏障膜的促成骨作用及作用方式  

Studies on Curative Effect and Osteogenesis in the Process of Bone Defect Repair by Pedicle Fascial Flap as Membrane Material and GBR Technique

作　　者：胡振顺[1] 杨新明[2] 王耀一[1] 孟宪勇[2] 张瑛[2] 阴彦林[2] 

机构地区：[1]河北北方学院,河北张家口075000 [2]河北北方学院附属第一医院骨科,河北张家口075000

出　　处：《河北北方学院学报（自然科学版）》2011年第6期62-69,共8页Journal of Hebei North University:Natural Science Edition

基　　金：河北省医学科学研究重点课题计划项目(编号:20100481);河北省科学技术研究与发展指导计划项目(编号:09276102D-46);河北省张家口市科学技术与发展指令计划项目(编号:0807045D-10);河北北方学院校级科研指令计划项目(编号:2009036)

摘　　要：目的研究带蒂筋膜瓣为引导性骨再生技术屏障膜的促成骨作用及其作用方式.方法 50只成年新西兰大白兔,雌雄不限,尺骨造2cm骨缺损模型,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(带蒂筋膜瓣),使其包裹由自体骨髓基质干细胞与含骨形态发生蛋白的骨诱导活性材料构建的非细胞型组织工程骨并充填骨缺损,A组为单纯非细胞型组织工程骨组(对照组),B组为带蒂筋膜瓣包裹非细胞型组织工程骨组(实验组),术后第4、8、12、16周进行骨修复区X射线检查、大体观察和组织学检查、骨形态计量分析,第8、12、16周进行生物力学测定分析.结果 X线片、骨形态计量分析,植入物内部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,B组均明显优于A组.术后4、8、12、16周新生骨小梁面积占修复总面积比值比较,以及B组内不同时间点比较差异均有统计学意义(P<0.05).生物力学测定分析显示,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).结论以带蒂筋膜瓣为引导性骨再生技术屏障膜具有明显促成骨作用,其促成骨作用具有明显的引导骨再生作用特点.Objective To study the curative effect and osteogenesis in process of critical size bone defect repair using pedieal faseial flap with vessels as membrane material and bone regeneration technique. Methods 50 New Zealand rabbits with 5-month-old were used to prepare hibateral periosteum-including bone defect models in the middle of ulna and the length of defect was 2era. Autologous red bone marrow was implanted in osteoinductive absorbing material to prepare tissue engineering bone. The prepared uncellular tissue engineering compound was implanted in bone defect area and those whose defects were not wrapped by anything were divided into Group A while those whose defects were wrapped by pedical fascial flap with blood supply were divided into Group B. In weeks 4, 8, 12, and 16 after operation, rabbits in each group were examined by the radiograph （X-ray）, light density measurement, gross morphology and histological inspection, bone shape measurement was analyzed in junctional zone. In weeks 8, 12, 16 they were examined by biomechanics determination. The data were analyzed Statistically to check the difference of bone defect repair. Results The indexes in gross morphology and histological inspection, radiograph, bone shape measurement analysis, quantity and forming speed of bone trabecula and cartilagi nous tissue, formation of mature bone structure, remodeling of diaphysis, recanalization of cavum ossis and absorption and degradation of implant group of pedical fascial flap with blood supply, Group B was superior to that of Group A obviously. By comparision of light density measurement and biomechanics determination, the difference between two groups in weeks 12, 16 after operation and the difference of the same group at each time point all bad statistical significance （P d0.05）. In weeks 4, 8, 12, 16 after the operation the ratio between new bone trabecular area and total area had significant difference （ P〈 0.05）. Conclusion The pedical fascial flap with vessels can be used in guided bone regenerati

关 键 词：骨缺损 带蒂筋膜瓣 膜诱导性骨再生 组织工程骨 

分 类 号：R683[医药卫生—骨科学]