负压封闭引流联合游离植骨血管化的研究  

A study on revascularization after the treatment of vacuum sealing drainage technology combined bone graft for bone and soft tissue composite defect

作　　者：邓凯[1] 陶圣祥[1] 夏成焱[1] 李宗焕[1] 王伟阳[1] 

机构地区：[1]武汉大学中南医院显微骨科,430071

出　　处：《中华实验外科杂志》2013年第10期2185-2187,共3页Chinese Journal of Experimental Surgery

基　　金：湖北省自然科学基金资助项目（2012FFB04311）;武汉大学博士生自主科研项目（2012303020203）.

摘　　要：目的 观察负压封闭引流技术联合游离植骨方法治疗骨缺损的效果及其血管化的影响.方法 建立双侧兔桡骨缺损的模型,通过创面一般愈合情况、X线、苏木素-伊红（HE）染色、免疫组织化学及实时定量聚合酶链反应（Real-time PCR）检测来评价效果.结果 实验组术后创面肉芽质量及愈合率好于对照组,恢复时间小于对照组,4周时X线示骨折愈合率显著高于对照组,HE染色血管组织较对照组丰富；血管内皮生长因子（VEGF）免疫组织化学及实时定量PCR结果均明显高于对照组,差异均有统计学意义（P＜0.05）.结论 负压封闭引流联合游离植骨可以有效的修复骨与软组织复合缺损,其机制可能是通过上调VEGF表达在促进游离植骨血管化来实现的.Objective To study the feasibility and efficiency of vacuum sealing drainage （VSD） technology combined with bone graft and its influence on revascularization.Methods Twenty-four rabbits with bone and soft tissue defects were randomly divided into experimental group （VSD therapy with open bone graft） and control group （only open bone graft）.The curative efficacy was assessed by wound conditions and wound healing time,X-ray examination,immunohistochemistry,and real-time quantitative polymerase chain reaction （Real-time PCR）.Results Wounds and bone defects in experimental group tended to have shorter healing time and healthier wound conditions.Hematoxylin and eosin （HE） staining showed that the graft in experimental group produced plentiful micrangium.The expression of vascular endothelial growth factor （VEGF） via immunohistochemistry and Real-time PCR was significantly higher in experimental group than in control group.Conclusion The VSD therapy combined with open bone graft can be used as a feasible and valuable method to treat composite bone and soft tissue defect,and it may promote revascularization of the graft through up-regulating the expression of VEGF.

关 键 词：负压封闭引流 开放植骨 骨缺损 血管化 

分 类 号：R687.3[医药卫生—骨科学]