两种不同方法治疗股骨头缺血坏死的实验研究  

Two different method to treat ischemic necrosis of femoral head

作　　者：李毅[1] 陶天遵[1] 陶树青[1] 吴立萍 

机构地区：[1]哈尔滨医科大学附属第二医院骨科,黑龙江哈尔滨150086

出　　处：《哈尔滨医科大学学报》2000年第6期412-414,F003,共4页Journal of Harbin Medical University

摘　　要：目的　观察股骨头坏死的病理变化 ,观察带血运骨瓣移植术与带血运骨瓣与骨膜生发层细胞复合移植术的疗效 ,比较两种治疗方法之间是否有差别 ,探讨血供重建与骨重建相结合的可能性。方法　 2 2只哈白兔分为 3组 ,均将股骨头截下后埋于胸部皮下 ,制成股骨头坏死模型。3周后 ,A组对照组 6只 ,无处置 ;B组 8只 ,将带血运肋骨瓣植入已坏死的股骨头内 ,C组 8只 ,将带血运肋骨瓣与骨膜生发层细胞复合植入已坏死的股骨头内。 12周后 ,光镜、透射电镜观察股骨头的软骨及骨小梁的结构。结果　A组出现典型骨坏死而无修复。B组出现成骨细胞及红细胞 ,修复反应出现。C组出现修复反应 ,且修复效果优于B组。结论　应用哈白兔将股骨头截下后埋藏于皮下 ,可以制作出动物模型。带血运肋骨瓣组可以见到有明确的血供重建 ,使坏死股骨头恢复血液供应 ;带血运肋骨瓣与游离骨膜生发层细胞复合移植组较快地诱发了骨重建 ,从而加快坏死骨修复 ,实验性血供重建与骨重建复合移植组对骨坏死的修复优于单纯血供重建组。Objective To observe the pathological changes of femoral head necrosis,to observe treatment result of vascular bone grafting,and vascular bone together with free endosteum cells combine grafting,to contrast two treatments and inquire he possibility to combine blood remodeling with bone remodeling. Methods Twenty two Harbin rabbits were divided into three groups. All rabbits left femoral head were cut off and buried under left chest skin to make necrosis model of femoral head. Three weeks later, A group: six rabbits were no treatment; B group: eight rabbits, the necrosic femoral head were transplanted by vascular rib bone; C group: eight rabbits, the necrosic femoral head were transplanted by vascular rib bone and free endosteum cells. Twelve weeks later,the articular cartilage and trabeculae of femoral head were observed by using optical microscope. Results A group models had typical necrosis and unimproved; B group models were improved; C group models were repaired and better than that of B group.Conclusion The model rabbit can make an routine animal model to study treatment ways of ischemic necrosis of femoral head. The group of vascular rib bone has definite blood remodeling,recovers blood supplying of necrosic femoral head. The group of vascular rib bone and free endosteum cells compound grafting also has definite blood remodeling and better in bone remodeling than that of B group.

关 键 词：股骨头缺血性坏死 血供重建 骨重建 

分 类 号：R681.805[医药卫生—骨科学]