可注射珊瑚人工骨与经皮球囊成型修复股骨头坏死  

Percutaneous balloon angioplasty combined with injectable coral artificial bone repairs femoral head necrosis

作　　者：朱康华 孟志斌[1] 黄涛[1] 谭海涛[1] 孙博[1] 庞学毅 

机构地区：[1]海南医学院附属医院脊柱骨病外科,海南省海口市570102 [2]贵阳中医学院,贵州省贵阳市550000

出　　处：《中国组织工程研究》2016年第25期3687-3692,共6页Chinese Journal of Tissue Engineering Research

基　　金：海南省科技厅重点科技项目(ZDXM20120053)~~

摘　　要：背景:目前治疗股骨头坏死的方法有很多,如髓芯减压、骨移植及关节塑形、关节置换等,每一种方法都有自身的缺点。经皮球囊合并珊瑚人工骨为治疗股骨头坏死提供了一种新的尝试。目的:观察可注射珊瑚人工骨合并经皮球囊成型修复股骨头坏死的有效性。方法:将24只杜洛克仔猪随机分为实验组与对照组,均采用液氮冷冻法建立双侧股骨头坏死模型,实验组选择其中一侧行经皮球囊合并含骨髓间充质干细胞的可注射珊瑚人工骨植入治疗,对照组选择一侧行骨水泥填充治疗,另一侧均不做治疗,作为空白对照组。术后2,4,8,16周进行X射线、生物力学与组织学检测。结果与结论:(1)X射线结果:术后16周,实验组有大量新骨生成,人工骨与周围边界模糊;对照组未见新生骨生成,材料与周围边界清晰;空白对照组股骨头表面发生塌陷,骨小梁紊乱,被破坏;(2)生物力学结果:实验组术后不同时间点的生物力学优于对照组、空白对照组(P<0.05);(3)组织学变化:术后16周,实验组珊瑚人工骨周围可见大量骨小梁及骨细胞生成,珊瑚人工骨大部分溶解;对照组骨水泥呈现无规律的状态,未见骨小梁生成;空白对照组塌陷区骨小梁连续性破坏,结构散乱;(4)结果表明:可注射珊瑚人工骨合并经皮球囊成型修复股骨头坏死,可促进新骨生成。BACKGROUND： There are many methods for the treatment of femoral head necrosis, such as core decompression, bone graft, arthroplasty and joint replacement, and each of which has its own shortcomings. So, percutaneous bal oon angioplasty combined with coral artificial bone provides a new attempt for the treatment of femoral head necrosis. OBJECTIVE： To observe the effect of percutaneous bal oon angioplasty combined with coral artificial bone on femoral head necrosis repair. METHODS： Twenty-four Duroc piglets were enrol ed to establish bilateral femoral head necrosis models by liquid nitrogen freezing method. Then, model piglets were randomly treated with percutaneous bal oon angioplasty combined with injectable coral artificial bone （experimental group） or bone cement （control group） on one affected side, and meanwhile, given no treatment on the contralateral side （blank control group）. At 2, 4, 8 and 16 weeks after surgery, X-ray examination, biomechanical test and histological detection were conducted. RESULTS AND CONCLUSION： X-ray showed that at 16 weeks after surgery, numerous new bones could be found in the experimental group and there was a fuzzy boundary between the artificial bone and surrounding tissues; no new bone formed in the control group, and the boundary was clear; in the blank control group, the surface of the femoral head col apsed, and bone trabeculae arranged disorderly, which were seriously destroyed. And in the histological detection at 16 weeks after surgery, there were numerous bone trabecula and osteoblasts around the coral bone in the experimental group, and the coral artificial bone almost dissolved; in the control group, bone cement was in an irregular shape and no bone trabecula formed; in the blank control group, bone trabecula were damaged in the col apsed area, whose structure was in disorder. Additional y, biomechanical changes in the experimental group were significantly better than those in the other two groups at different time points after surgery （P 〈 0.

关 键 词：生物材料 骨生物材料 可注射珊瑚人工骨 经皮球囊后凸成形 间充质干细胞 股骨头坏死 

分 类 号：R318[医药卫生—生物医学工程]