吻合骺动脉重建猪股骨头血供的实验研究  

Experimental study on reconstruction of blood supply of pig femoral head by anastomosis of epiphyseal artery

作　　者：王宏宇[1,2] 邓伟 张向南[2] 耿凯龙 刘澒洞 万家明 李雷 鞠文 汪丁松 周正虎 石卫军 侯瑞兴 WANG Hongyu;DENG Wei;ZHANG Xiangnan;GENG Kailong;LIU Hongdong;WAN Jiaming;LI Lei;JU Wen;WANG Dingsong;ZHOU Zhenghu;SHI Weijun;HOU Ruixing(Suzhou Medical College of Soochow University,Suzhou,Jiangsu,215123;Suzhou Ruihua Orthopedic Hospital,Suzhou,Jiangsu,215104;Clinical College of Medical College of Yangzhou University,Yangzhou,Jiangsu,225009)

机构地区：[1]苏州大学苏州医学院,江苏苏州215123 [2]苏州瑞华骨科医院,江苏苏州215104 [3]扬州大学医学院临床学院,江苏扬州225009

出　　处：《实用临床医药杂志》2022年第24期125-129,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省研究生科研与实践创新计划项目(SJCX22_1515);江苏省苏州市青年科技项目(KJXW2021081)。

摘　　要：目的通过活体验证吻合猪股骨头内骺动脉Ⅰ期重建股骨头血供的可行性。方法选取9头体质量约100 kg的普通级长白猪,制作股骨颈头下型骨折模型。将右后肢作为实验组,左后肢作为对照组。实验组行内固定后,在股骨头内吻合骺动脉,对照组行内固定后不予其他处理。术中和术后7 d,观察并计算吻合口通畅率、股骨头渗血率、数字减影血管造影(DSA)阳性率。术后7 d,取双侧股骨头行组织学检查,并计算软骨厚度。结果本研究有1头猪术中死亡,8头猪有完整资料。实验组术中吻合口通畅率为100.0%,股骨头渗血率为100.0%,DSA阳性率为25.0%;实验组术后7 d吻合口通畅率为12.5%,股骨头渗血率为12.5%,DSA阳性率为12.5%。组织学检查显示,实验组软骨厚度大于对照组,差异有统计学意义(P<0.01)。结论在活体猪中Ⅰ期吻合股骨头内骺动脉重建股骨头血供的方法是可行的,短期内是有效的。Objective To verify the feasibility of anastomosing the epiphyseal artery of the pig femoral head in vivo in the first stage of reconstruction of the blood supply of the femoral head.Methods Nine ordinary Landrace pigs weighing about 100 kg were used to make subcephalic fractures of the femoral neck.The right hindlimb was used as experimental group,and the left hindlimb was used as control group.The epiphyseal artery was anastomosed in the femoral head after internal fixation in the experimental group,while no other treatment was done after internal fixation in the control group.The patency rate of anastomosis,the blood oozing rate of femoral head and the positive rate of digital subtraction angiography(DSA)were observed and calculated during operation and 7 days after operation.The bilateral femoral heads were taken for histological examination at 7 days after operation.Results In this study,one pig died during operation,and 8 pigs had complete data.In the experimental group,the intraoperative anastomotic patency rate was 100.0%,the intraoperative blood oozing rate of femoral head was 100.0%,and the intraoperative positive rate of DSA was 25.0%;at 7 days after operation in the experimental group,the intraoperative anastomotic patency rate was 12.5%,the intraoperative blood oozing rate of femoral head was 12.5%,and the intraoperative positive rate of DSA was 12.5%.Histological examination showed that the thickness of cartilage in the experimental group was significantly greater than that in the control group(P<0.01).Conclusion It is feasible to reconstruct the blood supply of the femoral head by anastomosis of the internal epiphyseal artery of the femoral head in the first stage in living pigs,and the effect is effective in the short term.

关 键 词：股骨颈骨折 股骨头 血供重建 再植术 

分 类 号：R816.8[医药卫生—放射医学] R364.1[医药卫生—临床医学]