异种骨复合壳聚糖／去甲万古霉素缓释材料治疗家兔感染性骨缺损  

Xenogenic bone with chitosan / norvancomycin sustained-release system for treatment of infectious bone defects in rabbits

作　　者：罗春山 杨超 孙宇 叶川 陆延盛 姚书耽 蒲兴魏 杨建文 赵国权 田晓滨 

机构地区：[1]贵州省骨科医院骨科,贵阳550002 [2]贵州医科大学研究生院 [3]贵州医科大学附属医院骨科

出　　处：《中华创伤杂志》2018年第1期68-73,共6页Chinese Journal of Trauma

基　　金：贵州省科学技术厅基金[SY（2010）3114号]

摘　　要：目的探讨异种骨复合壳聚糖／去甲万古霉素缓释材料治疗家兔感染性骨缺损的效果。方法通过静电纺丝技术制得异种骨／壳聚糖／去甲万古霉素复合材料。用耐甲氧西林金黄色葡萄球菌制造感染性骨缺损家兔模型，根据感染程度Norden评分〉3分为建模成功。按随机数字表法分为对照组和实验组，每组各8只。对照组：仪在病灶处行单纯清创处理；实验组：病灶处彻底清创后植入复合壳聚糖／去甲万古霉素的异种骨骨粒。术后观察家兔一般情况、骨缺损修复情况、X线表现、HE染色组织学检查和细菌学检查结果。结果实验动物造模后1个月X线片显示明显骨质破坏、死骨形成、骨膜反应及软组织肿胀影，Norden评分为（3．84±0．52）分。治疗后2个月实验组大体观察一般情况好，窦道已愈合；对照组一般情况差，窦道红肿、流脓，2只实验期间死于败血症。胫骨大体观察病理评分实验组为（0．41±0．08）分，对照组为（3．27±0．26）分（P〈0．05）。骨缺损修复情况：实验组骨缺损基本得到修复，骨缺损最长径为（0．11±0．02）cm，对照组为（0．48±0．06）cm（P〈0．05）。X线片表现：实验组未见明显骨髓炎征象，骨缺损修复良好，Norden评分为（1．32±0．23）分；对照组可见明显骨膜反应及软组织肿胀影，大量骨质破坏及死骨形成，Norden评分为（5．21±0．48）分（P〈0．05）。组织学观察：HE染色示实验组可见大量成骨细胞、骨小梁形成、纤维增生，未见明显感染征象，组织学评分为（0．61±0．10）分；对照组可见炎性细胞浸润、坏死组织及死骨形成，组织学评分为（4．21±0．41）分（P〈0．05）。细菌学检查：细菌培养阴性率实验组为33％，对照组为100％（P〈0．05）。结论通过静电纺丝技术制备的异种骨复合壳聚糖／去甲万古霉素缓释材料治疗家兔感Objective To investigate the effects of xenogenic bone with chitosan/norvancomycin sustained-release biomaterials in treating infectious bone defects in rabbits. Methods Xenogenic bone with ehitosan/norvaneomycin sustained-release biomaterials was made hy electrospinning technique. Rabbit infectious bone defect models were made by Methieillin-resistant Staphylococcus aureus. A successful model was evaluated with the standard of more than three points in Norden score assessment. All models were divided into two groups by random number table method, with eight models in each. The control group was treated with surgical debfidement, and the experimental group was implanted with bone particles of xenogenie bone with chitosan/norvaneomycin sustained-release system ＇after debridement. Postoperatively, general conditions, X-ray, histological results of HE staining, and bacteriological examination results of the rabbits were observed. Results X-ray showed significant bone defects, sequestration, periosteal reaction, and soft tissue swelling after one month of modeling, with Norden score of （3. 84 ± 0. 52 ） points. The general conditions were good and the sinus tracts were healed in experimental group after two months of treatment. The control group demonstrated generally poor conditions with swollen sinus and purulent discharge. Two rabbits were died of sepsis. The pathological scores of tibial were （ 0.41 ±0.08 ） points in experimental group, and （ 3.27± 0.26 ） points in control group by gross observation. The pathological score of experimental group was significantly lower than control group（ P 〈 0.05 ）. The bone defects were basically repaired in experimental group. The longest diameter of bone defect in experimental group was （0.11± 0.02） cm, significantly smaller than （0.48±0.06） cm in control group （ P 〈 0.05）. There were no obvious signs of osteomyelitis and the bone defects were well repaired in experimental group. Periosteal reaction, soft tissue swelling, a substantial num

关 键 词：骨髓炎 壳聚糖 抗菌药 药物释放系统 

分 类 号：R318.08[医药卫生—生物医学工程] R687.3[医药卫生—基础医学]