带蒂筋膜瓣的稳定性对其促超临界骨缺损成骨作用影响的实验研究  

Study about effect of the pedicle fascial flap stability to supercritical bone defect osteogenesis

作　　者：王海波[1] 杨新明[2] 赵御森[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9期1044-1048,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,将带蒂筋膜瓣作为膜引导材料,研究带蒂筋膜瓣的稳定性提高后对其促超临界骨缺损成骨作用的影响。方法 30只新西兰大白兔,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上制备非细胞型组织工程骨,并植入双侧骨缺损区,左侧采用单纯带蒂筋膜瓣包裹,设为对照组,右侧采用带蒂筋膜瓣包裹后行微型钛板内固定术,设为实验组。术后对实验动物进行一般情况观察,并在第4、8、12、16周后进行标本大体观察,尺骨X射线检查,修复区组织学检查及骨形态计量分析,并在12、16周行生物力学测定分析。结果实验组一般情况表现优于对照组;大体观察示实验组外骨痂形成的量及速度优于对照组;X射线检查结果示实验组强于对照组;修复区组织学检查新生骨结构形成的数量和速度实验组优于对照组。术后4、8、12、16周新生骨小梁面积占修复总面积比值及两组内不同时间点比较,差异均有统计学意义(P<0.05)。生物力学测定分析显示,术后12、16周两组间比较及同组内各时间点间比较,差异均有统计学意义(P<0.05)。结论膜结构的稳定性提高后,膜下空间及植骨区得到更好的维持,有利于超临界骨缺损的修复。Objective To study the effect of the pedicle fascial flap stability to supercritical bone defect osteogenesis by membrane guided bone regeneration technique,using the pedicle fascial flap as the membrane guided material.Methods 30 New Zealand rabbits were constructed a 1 cm long bone defect model with periosteum in the middle of both ulnas.The unicellular tissue engineered bone,which was implanted into the bilateral bone defect areas,was prepared by seeding the autologous red bone marrow obtained from the rabbits on the osteoinduction active material（OAM） containing bone morphogenetic protein（BMP）.The left side was wrapped by pedicle fascial flap merely as Group A（control group）,while the right side was wrapped by pedicle fascial flap and performed with internal fixation of miniature titanium as Group B（experimental group）.The general state of health was observed after the operation in both groups.At the 4 th,8 th,12 th and 16 th week after the operation,each group was observed by gross morphology,examined by X-ray radiograph of the ulna,histological examination and bone shape measurement analysis in the reparative area,and meanwhile the biomechanical detection was performed at the 12 th and 16 th week.Results Group B was superior to Group A in all of the aspects in the general state of health observation.The quantity and the forming speed of external callus by gross morphology,X-ray film,the quantity and the forming speed of newly formed bone by histological examination in the reparative area of Group B were superior to Group A.Comparing the new trabecular bone area for repair of total area ratio on the 4 th,8 th,12 th and 16 th week after the operation and those at different time points between the two groups,all the differences had statistical significance（P0.05）.The biomechanics test analysis showed that all the differences had statistical significance（P0.05） by comparing Group A and Group B and the same group at different time points.Conclusion Promoting the membrane stability can sus

关 键 词：带蒂筋膜瓣 膜引导性骨再生 组织工程骨 超临界骨缺损 

分 类 号：R318[医药卫生—生物医学工程]