自体富血小板血浆联合自体骨移植术治疗兔桡骨骨不连实验研究  

Experimental study of autologous platelet-rich plasma combined with autologous bone grafting in the treatment of rabbit radial nonunion

作　　者：陈植 徐芳露 陈兵乾[1] CHEN Zhi;XU Fanglu;CHEN Bingqian(Department of Orthopedics,Changshu No.1 People's Hospital,Jiangsu 215500;Department of Nephrology,Changshu No.2 People's Hospital)

机构地区：[1]常熟市第一人民医院骨科,江苏215500 [2]常熟市第二人民医院肾内科

出　　处：《交通医学》2024年第1期6-10,共5页Medical Journal of Communications

基　　金：常熟市卫生健康委员会资助性青年项目(cswsq202003)。

摘　　要：目的:观察自体富血小板血浆(platelet-rich plasma,PRP)联合自体骨移植术治疗兔桡骨骨不连的效果。方法:成年新西兰兔96只,随机分为PRP-植骨组、单纯植骨组和对照组各32只。将所有实验兔左前臂桡骨中段截除1 cm骨段,骨蜡封闭断端髓腔,制成骨不连动物模型。PRP-植骨组采用自体髂骨植入骨折端+骨折端注射自体PRP治疗,单纯植骨组仅在骨折端植入自体髂骨,对照组不作处理。术后2、4、8、12周时采用大体形态观察、X线摄片、Micro-CT检查、组织学观察及生物力学检测等手段对骨不连愈合情况进行评估。结果:大体观察、X线摄片、Micro-CT、组织学及生物力学检测结果显示,与单纯植骨组比较,PRP-植骨组术后2、4周时软骨细胞增生明显增多,术后8周时已有明显骨痂形成。PRP-植骨组术后2、4、8、12周被破坏时的最大载荷(payload-maximum,Pm)及破坏弯矩(moment,M)均高于同期单纯植骨组,差异均有统计学意义(P<0.05)。结论:自体富血小板血浆联合骨移植术治疗兔桡骨骨不连效果良好,骨愈合速度更快,骨愈合强度更高。Objective:To observe the effect of autologous platelet-rich plasma(PRP)combined with autologous bone grafting in the treatment of rabbit radial nonunion.Methods:Ninety-six adult New Zealand rabbits were randomly divided into three groups with 32 rabbits in each group,which were named as PRP-bone grafting group,the simple bone grafting group and the control group.A 1 cm bone segment was excised from the middle radium of the left forearm of all the rabbits in the three groups.The medullary cavity of the broken end was closed with bone wax.The rabbits in PRP-bone grafting group were treated with autologous iliac bone grafting and injection of autologous PRP at the fracture end,the rabbits in the simple bone grafting group were treated with autologous iliac bone grafting at the fracture end and the rabbits in the control group were not treated.At 2,4,8 and 12 weeks after operation,gross morphological observation,X-ray,Micro-CT,histological analysis,and biomechanical test were used to evaluate the healing of bone nonunion.Results:The results of gross observation,X-ray film,Micro-CT,histology and mechanical examination showed that the proliferation of chondrocytes in PRP-bone grafting group was significantly higher than that in the simple bone grafting group at 2 and 4 weeks after operation,and callus formation was obvious at 8 weeks after operation.The payload-maximum(Pm)and failure moment(M)in PRP-bone grafting group were higher than those in the simple bone grafting group at 2,4,8 and 12 weeks after operation(P<0.05).Conclusion:The effect of autologous PRP combined with bone grafting in the treatment of rabbit radial nonunion is good,and the bone heals faster and stronger.

关 键 词：实验兔 骨不连 富血小板血浆 骨移植术 生物力学 

分 类 号：R683.41[医药卫生—骨科学]