比较带蒂筋膜瓣与生物膜包绕组织工程骨修复兔超临界骨缺损的实验研究  

Comparision of pedical fascial flap with biomembrane wrapping tissue engineering bone repairs rabbit supercritical bone defect

作　　者：赵御森[1] 杨新明[2] 王海波[1] 

机构地区：[1]河北北方学院研究生部,张家口075000 [2]河北北方学院附属第一医院骨外科,张家口075000

出　　处：《安徽医科大学学报》2013年第6期621-625,共5页Acta Universitatis Medicinalis Anhui

基　　金：河北省卫生厅2010年医学科学研究重点资助项目(编号:20100481);河北省2009年科学技术研究与发展计划医学科学研究重点课题资助项目(编号:09276102D-46);张家口市2008年科学技术与发展指令计划资助项目(编号:0807045D-10);河北北方学院2009年校级科研指令计划资助项目(编号:2009036)

摘　　要：目的利用膜引导骨再生技术,以带蒂筋膜瓣与生物膜作为膜引导材料,比较二者在修复超临界骨缺损方面的疗效。方法 30只成年新西兰大白兔,不限雌雄,制备双侧尺骨中段连同骨膜1 cm骨缺损模型,将自体红骨髓接种于含骨形态发生蛋白的骨诱导活性材料制备非细胞型组织工程骨,并植入双侧骨缺损区,左侧骨缺损区采用可吸收医用膜包裹,设为对照组,右侧骨缺损区采用带蒂筋膜瓣包裹,设为实验组。两组术中均行微型钛板内固定术。术后观察实验动物一般情况,4、8、12、16周行实验动物尺骨X射线检查、修复区大体观察、组织学检查、修复区内骨形态计量分析,并在12、16周行生物力学检测。结果实验组动物一般情况表现优于对照组;X射线检查术后16周实验组髓腔完全贯通,对照组髓腔仍封闭,实验组骨缺损的骨密度高于对照组,植入物的降解吸收程度强于对照组;大体观察示实验组外骨痂形成的量及速度优于对照组;组织学检查示实验组骨小梁、软骨组织、成熟骨结构形成的数量和速度、骨干结构的重塑均优于对照组。骨形态计量分析术后4、8、12、16周两组新生骨小梁面积占修复总面积比值及不同时间点比较,差异均有统计学意义(P<0.05)。生物力学检测结果显示,术后12、16周两组间比较及组内各时间点比较,差异均有统计学意义(P<0.05)。结论带蒂筋膜瓣的膜引导成骨作用显著,其联合非细胞型组织工程骨技术修复超临界骨缺损的疗效明显。Objective To compare the effect of pedical fascial flap and biomembrane in repairing the exceed criti- cal size bone defect by membrane guided bone regeneration techniques（MGBR）. Methods 30 New Zealand white rabbits （ male or female） were 5 months old and used to make the experimental model of bilateral i cm defect in the middle of the ulna with the periosteum. The uncellular tissue engineered bone, which was implanted into the bilateral bone defect areas, was prepared by seeding the autologous red bone marrow （ARBM） obtained from the rabbits on the osteoinductive absorbing material containing bone morphogenetic protein（BMP）. The left side of bone defect area was wrapped by biomembrane as control group, while the right side was wrapped by pedieal faseial flap as experimental group. The two groups were performed with internal fixation of mini titanium plate. On 4 week, 8 week, 12 week, and 16 week after the operation, each group was examined by X-ray radiograph, gross morphology and histological examination, bone shape measurement analysis in the reparative area, and the biomechanical detection was conducted on 12 week and 16 week. Results Experimental group was superior to control group in the gross morphological inspection; by the observation of X-ray radiograph at the 16 th week after the operation, cavum ossis was recanalization completely, while control group still blocking, and bone density of experimental group was higher than control group, the level of the degradation and absorption of the implant was better, the quantity and the forming speed of external callus was superior, and bone trabecula, cartilaginous tissues and mature bone structure in the histological examination, the remodeling of diaphysis structure were all superior to control group. By the analysis of the bone shape measurement, the differences at the ratio of new bone trabecula area to total reparative area among three groups and the differences at the different time points on 12 week and 16 week after the operation were st

关 键 词：带蒂筋膜瓣 生物膜 膜引导性骨再生 骨缺损 组织工程骨 

分 类 号：R318[医药卫生—生物医学工程]