二次创伤对实验性松质骨缺损修复的影响  

Effects of secondary injury on repairing of experimental cancellous bone defect

作　　者：王长海 马志新[2] 李晓东[2] 栗平[2] 

机构地区：[1]内蒙古自治区人民医院骨科,呼和浩特010010 [2]内蒙古医学院第二附属医院,呼和浩特010050

出　　处：《中华损伤与修复杂志（电子版）》2012年第3期32-35,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的观察二次创伤对实验性松质骨缺损修复的影响。方法选用中国家兔60只,在其双侧股骨髁各造成一个直径6.0mm、深12.0mm的孔洞状骨缺损,左侧为实验组,右侧为对照组。4周后,对实验侧采用自制微型剥离器插入骨缺损处做反复地切割,以造成二次创伤模型。分别于骨缺损模型制成后1d、1周、2周、3周、4周各处死6只家兔;于经皮骨折端二次创伤术后1d(骨钻孔术后4周+1d)、1周、2周、4周、8周各处死6只家兔,行X线拍片检查后,于双侧骨缺损区取材。使用HE染色技术对标本进行检测和观察。结果大体观察,实验组二次创伤后8周(骨钻孔术后12周)可见新骨充填骨缺损区;对照组骨钻孔术后12周孔洞内组织质软,色黄,缺损依然为纤维结缔组织填充。X线观察,实验组从二次创伤后4周开始有修复倾向,缺损范围渐小,二次创伤后8周时几乎看不到明显缺损;对照组骨缺损一直未修复,骨钻孔术后12周可见典型硬化环。HE染色观察,实验组二次创伤后缺损内可见成纤维细胞、成骨细胞和骨细胞等逐渐增多,二次创伤后8周时新骨逐渐填充缺损,但骨小梁较正常松质骨稀疏,仍可见少量纤维结缔组织。对照组骨钻孔术后12周时,缺损内可见少量成骨细胞,但缺损绝大部分由成熟的纤维结缔组织充填,同时可见大量脂肪组织。结论二次创伤可以促进松质骨缺损的修复,推测二次创伤能促进骨缺损区域血液循环改善,进而达到促进骨缺损愈合的目的 。Objective To observe the effects of secondary injury on repairing of experimental cancellous bone defect. Methods Sixty adult China rabbits were divided into ten groups. The cancellous bone defects of 6 mm in diameter, 12 mm in depth were created over both femoral condyles in 60 rabbits. The specimens of femoral condyles of six habits were collected postoperatively at 1 day, 1, 2, 3 and 4 weeks.Four weeks later,the secondary injury model was established by drilling in the defect of left femoral condyles, the defect of right femoral condyles was not drilled .The specimens of femoral condyles of six habits were collected postoperatively at 1 day, 1, 2, 4 and 8 weeks. Results Gross observation and X-ray and histological observation showed that the defects of left femoral were repaired at the twelfth week and the defects of right femoral could not heal spontaneously. Conclusions The results indicated that secondary injury could repair cancellous bone defects.We presume that secondary injury may promote blood circulation to improve the bone defects region and thus achieve the purpose of promoting bone defects healing.

关 键 词：创伤和损伤 成骨细胞 松质骨缺损 

分 类 号：R687.3[医药卫生—骨科学]