骨膜瓣复合异体骨移植修复大段骨缺损  

Bone Allograft Embedded by Vascularized Periosteum Flap for the Reconstruction of Segmental Bone Defect

作　　者：张大伟[1] 田清业[2] 刘光军[2] 刘雪涛[2] 王谦[2] 杨磊[2] 

机构地区：[1]潍坊医学院,山东省潍坊市261042 [2]解放军89医院全军创伤骨科研究所,山东省潍坊市261042

出　　处：《组织工程与重建外科杂志》2012年第1期26-31,共6页Journal of Tissue Engineering and Reconstructive Surgery

摘　　要：目的探讨带血管薄层皮质骨-骨膜瓣嵌入开窗的异体骨修复大段骨缺损的效果。方法将兔胫骨去抗原后制备异体骨标本,制作大段骨缺损动物模型。以带血管薄层皮质骨-骨膜瓣复合开窗的异体骨进行修复。将60只健康家兔随机分为3组:实验组、对照组及空白对照组。实验组以带血管薄层皮质骨-骨膜瓣嵌入开窗的异体骨进行修复;对照组以骨膜瓣直接包裹异体骨进行修复;空白对照组以异体骨直接进行修复。术后观察骨缺损大体标本及X线影像,对移植物及其周围软组织行组织学和免疫组织化学观察。结果实验组骨缺损骨痂形成并改造塑形,新生血管长入骨缺损处,其血管化、新骨形成和骨单位成熟均较对照组早。结论以带血管薄层皮质骨-骨膜瓣嵌入开窗的异体骨修复大段骨缺损的手术方法可缩短骨缺损修复的时间,优于以骨膜瓣直接包裹异体骨的方法。Objective To explore the effect of bone allograft embedded by vascularized thin cortex-periosteum flap for treatment of segmental bone defect. Methods The adult rabbit model of segmental tibial defect was established. The allograft de-antigenic rabbit tibia was designed and opened a window. Then the window was embedded by vascularized cortex-periosteum flap as a complex. Sixty healthy rabbits were randomly divided into 3 groups： experimental group, control group and blank group. In experimental group, the defect was repaired by complex, vascularized flap packing the allografts was used as the control group and only allografts was used as the blank group. X-ray examination, gross observation, histological observation and immunohistochemical examination were done on the bone and the surrounding tissues. Results In the experimental group, callus formation, transformation remodeling and neovascularization were observed. The vascularization, new bone formation and bone units mature were earlier in the experimental group than the control group. Conclusion Bone allograft embedded by vascularized thin cortex-periosteum flap could reduce the time of bone repair and has significant advantages compared to the directly packing model.

关 键 词：大段骨缺损 带血管薄层皮质骨-骨膜瓣 同种异体移植 

分 类 号：R687.34[医药卫生—骨科学]