自体软骨碎屑回植后的生物力学研究  

Biomechanics research of autologous cartilage debris replantation

作　　者：光君 李先慧[2] 裴蛟淼[1] 张栋梁[1] 杨阳[1] 苏映军[1] 马显杰[1] 郭树忠[1] 

机构地区：[1]第四军医大学西京医院全军整形外科研究所,陕西西安710032 [2] 中国人民解放军成都军区总医院

出　　处：《中国美容整形外科杂志》2015年第2期118-121,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 建立山羊自体肋软骨切取后软骨碎屑回植供区软骨膜的动物模型,以组织学、生物力学指标为观察对象,研究自体肋软骨碎块回植后的转归.方法 取8 ～12个月龄成年山羊12只随机分为3组,每组4只.肋软骨切取后,各组处理方法：Ⅰ组,直接将软骨膜缝合,形成封闭的空腔;Ⅱ组,将切取的肋软骨切碎成均匀的小碎块,将其回植填塞入肋软骨缺损处,总量约为缺损的1/5～1/4,缝合软骨膜封闭缺损;Ⅲ组,在Ⅱ组的基础上,在缺损段内喷入生物蛋白胶,使之充满回植入软骨碎屑的缺损腔隙,缝合软骨膜封闭;Ⅳ组,切取正常肋软骨作为对照,未做任何处理.术后16周处死并观察各组胸廓及修复段形态,利用生物力学检测各组肋软骨修复段强度.结果 Ⅰ～Ⅲ组胸廓形态良好,无塌陷,修复段组织与肋骨软骨连结处愈合较好,修复段呈纤维增生;组织学观察显示,Ⅰ～Ⅲ组修复组织主要为纤维组织,回植软骨均能存活,无明显增殖;压力、拉伸、折弯及撞击实验数据显示,Ⅱ组修复强度优于Ⅰ和Ⅲ组,但弱于Ⅳ组.结论 将软骨碎屑回植,虽不能促进软骨的再生修复,却能明显加强修复组织生物力学强度,加强胸廓的稳定性.Objective To build goat animal model of autologous costal cartilage debris replantation in perichondrium of donor area, investigating the effects by histology and biomechanics. Methods Twelve adult goats aged from 8 to 12months were randomly divided into 4 groups. The harvested cartilages were treated with suturing perichondrium directly to form cavity in the Ⅰ group; replanting 1/5 ~ 1/4 pieces into donor area after cutting cartilage into uniform pieces and then suturing the perichondrium to close the cavity in the Ⅱ group; plugging bioprotein jelly after cartilage replanting like the Ⅱgroup in the Ⅲgroup; the harvested cartilages were without treatment as the control group, the Ⅳ group. The experimental animals were sacrificed, the shape of chest and the repaired segment were observed, and then strength of costal cartilages was evaluated by HE staining and biomechanical testing at 16 weeks postoperatively. Results The shape of the chest in the Ⅰ , Ⅱ and Ⅲ groups was well without collapse and joints of repaired tissue and costal cartilages healed well with fibroplasias in the repaired segment. HE staining demonstrated the replanted cartilage survived well without significant proliferation, the experimental data of pressure, tensile, bending and impact showed that mechanical strength in the Ⅱ group were stronger than those in the Ⅰ and Ⅲ groups, but weaker than the IVgroup. Conclusion Replanting of autogeneic cartilage could strengthen thoracic cage mechanical strength by fibroplasias but could not enhance cartilaginous regeneration.

关 键 词：肋软骨 软骨碎屑 生物力学 胸廓稳定性 

分 类 号：R318.01[医药卫生—生物医学工程]