海水浸泡兔桡骨开放性骨缺损最佳植骨时间的研究  

Study on the best time for bone grafting in the case of open bone defect in rabbit radius with seawater immersion

作　　者：马武秀[1] 程迅生[1] 陈肖松[1] 张迪[1] 符来想[1] 

机构地区：[1]安徽医科大学解放军临床学院（解放军第一0五医院）骨科,合肥230031

出　　处：《中华航海医学与高气压医学杂志》2012年第2期85-90,共6页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：2009年南京军区医学科技创新经费资助项目（09MA039）

摘　　要：目的探讨海水浸泡兔桡骨开放性骨缺损最佳自体骨移植时间。方法取新西兰大白兔48只，采用数字表法随机分为0、3、7、14d植骨组，每组12只。于兔双侧桡骨中段截除15mm骨段后人工海水浸泡伤口3h。分别于清创后立即（0d）及浸泡后3、7、14d于骨缺损处植人自体髂骨。各组于植骨后第4、8、12周分批处死（每批4只兔，共8肢）。通过影像学、组织学观察植骨后的愈合情况。结果（1）0d植骨组肢体感染率为4．17％（1／24），3d植骨组肢体感染率为29．17％（7／24），7d植骨组肢体感染率为16．67％（4／24），14d植骨组肢体无感染情况发生。（2）植骨后第8周时，0d植骨组断端间为新骨者6肢，为软骨者2肢；14d植骨组断端间为新骨者4肢，为软骨者4肢。（3）植骨后第8周时，0d植骨组断端间骨痂灰度值为194．78±5．86，14d植骨组为183．99±5．97，2组比较差异有统计学意义（P〈0．05）。结论（1）海水浸泡兔桡骨开放性骨缺损，伤后3、7d植骨组感染发生率较高；伤后0、14d植骨组感染发生率低。（2）植骨后第8周，0d植骨组骨痂灰度值明显高于14d植骨组。由此可见，海水浸泡兔桡骨开放性骨缺损最佳植骨时间为清创后立即，即Ⅰ期植骨。Objective To investigate the best time for bone grafting in case of open bone defect in rabbit radius with seawater immersion. Methods Forty-eight New Zealand rabbits were randomly divided into the 0-day, 3-day, 7-day and 14-day bone grafting groups, each consisting of 12 rabbits. Fifteen millimeters of bone from the mid-section of radius were collected and then were immersed in the artificial seawater for 3 h. The autologous bone was grafted on the same day （0 day）, the 3rd day, the 7th day and the 14th day respectively following development of the model. After bone grafting, the animals of each group were sacrificed （4 rabbits per batch, with 8 limbs） in the 4th, 8th and the 12th weeks. Imaging and histologic observation were made on the healing of open bone defect with seawater immersion after autologous bone grafting. Results （1） The infection rate of the 0-day bone grafting group was 4.17% （1/24）, that of the 3-day bone grafting group was 29.17% （7/24）, that of the 7-day bone grafting group was 16.67% （4/24） and the 14-day bone grafting group had no infection. （2） In the 8th week after bone grafting,histopathological examination displayed that new bones could be seen in 6 limbs and ehondrogenesis be seen in 2 limbs at the osteotomy site in the 0- day group; And new bones in the 4 limbs and ehondrogenesis also in the 4 limbs were noted in the 14-day group. （3） In the 8th week after bone grafting, the grayscales of callus in the bone defect for the 0-day group were194. 78 ±5, 86 and the values for the14-day group were183. 99 ±5.97（P〈0.05）.Conclusions （1） In the case of open bone defect with seawater immersion, infection rates for the 3-day group and the 7-day group were higher, while infection rates for the 0-day group and the 14-day group were lower, and significant differences could be seen, when comparisons were made between them. （2） In the 8th week after bone grafting, the grayscales of callus for the 0-day bone grafting group was obviously higher than those

关 键 词：海水浸泡 开放性骨缺损 自体骨移植 植骨时间 

分 类 号：R687.3[医药卫生—骨科学]