ARBX与RBX治疗感染性骨缺损的实验对比  

Effects of anti-infective reconstituted bone xenograft and reconstituted bone xenograft on infective bone defect

作　　者：余升华[1] 胡汉生[1] 范震波[1] 李远辉[1] 杨展翔[1] 曹灿贤[1] 

机构地区：[1]广州医学院第三附属医院创伤外科,广东广州510150

出　　处：《广州医学院学报》2013年第2期43-46,共4页Academic Journal of Guangzhou Medical College

基　　金：广东省卫生厅医学科研基金(A2010267)

摘　　要：目的:研究抗感染重组合异种骨(ARBX)对感染性骨缺损的治疗作用。方法:在36只新西兰大白兔胫骨近端制备大小为0.8 cm×1.2cm×1.8 cm的矩形骨缺损并注入金色葡萄球菌,以构建感染性骨缺损模型,2周后再次手术清除病灶。实验分为ARBX组(植入ARBX)、RBX组(植入RBX)及对照组(不植骨),每组12只。术后12周对缺损修复情况行大体解剖学、影像学、组织学、细菌学观察。结果:ARBX组骨缺损骨皮质与髓腔组织结构接近正常,与相邻正常组织连接较佳,均无明显的骨髓炎表现,而RBX组标本外观显示骨折、死骨、脓液征象,修复新生骨增生与缺损交替存在,与相邻正常组织连接松散,髓腔可见炎症细胞和脓肿存在。ARBX组细菌计数及改良X线Norden感染分值低于其他两组(P<0.01)。结论:ARBX抗感染的同时可诱导成骨,是一种较理想的一期修复感染性骨缺损的植骨材料。Objective： To investigate the effects of anti-infective reconstituted bone xenograft （ ARBX ） on infective bone defect. Methods： The infective bone defect model was constructed by injection of staphylococci to the trapezoidal bone defect region 0.8 cm× 1.2 cm × 1.8 cm in size of the proximal tibia in 36 New Zealand rabbits. Following surgical clearance of the lesion at week 2, the rabbits were randomly assigned to receive implantation of ARBX （ group ARBX, n = 12） , reconstituted bone xenograft （ group RBX, n = 12） and nil treatment （control group, n = 12）, respectively. This entailed gross anatomical, imaging, histological and bacteriological examinations at week 12. Results： Group ARBX showed nearly normal structures of the cortex and medulla tissues that were satisfactorily connected with the normal adjacent tissues, suggesting an absence of osteomyelitis. Group RBX showed evidence of bone fracture, sequestrum and pus, with new bone formation and defect existing alternatively. The lesion in which inflammatory cells and pus may be noted was loosely connected with the normal adjacent tissues. Group ARBX yielded a lower bacterial count and modified X-ray score of infection compared with group RBX and control group （ both P 〈 0.01 ）. Conclusion： ARBX is a preferable implant material for repair of stage 1 infective bone defect owing to its capacity of anti-infection and induction of bone formation.

关 键 词：抗感染重组合异种骨 感染性骨缺损 骨移植 

分 类 号：R681.2[医药卫生—骨科学]