明胶与京尼平粘合自体颗粒骨修复兔桡骨缺损的实验研究.docVIP

明胶和京尼平粘合自体颗粒骨修复兔桡骨缺损的实验研究 　　作者：曾荣，吴少科，郭伟韬，谭志，胡资斌 作者单位：广东医学院附属医院 1.骨外科;2.放射科，广东湛江 524001 　　【摘要】 目的 探讨以明胶和京尼平粘合自体颗粒骨修复新西兰大白兔桡骨缺损的效果，为临床应用提供依据。方法 取24只新西兰大白兔制成双侧前臂桡骨中段骨缺损模型，并将切除的骨质磨成颗粒骨，随机分为A、B、C、D 4组，每组为6只，A组为空白组不填充任何材料;B组单纯填充明胶、京尼平;C组单纯植入400 mg自体颗粒骨;D组填充明胶、京尼平+200 mg自体颗粒骨。各组术后2、4、8周时各处死动物兔2只，取材检测，通过观察大体标本、X线片、组织学检查评估骨缺损修复能力。结果 在术后各时期，A、B组骨缺损模型均无骨愈合迹象，形成陈旧性骨缺损。术后C、D组均有良好的骨修复效果，但D组在防止颗粒骨移位流失、骨融合程度、新骨形成量、骨塑形改建方面优于C组。结论 明胶、京尼平具有粘合自体颗粒骨修复骨缺损的能力。 　　【关键词】 自体颗粒骨;明胶;京尼平;骨缺损 　　Autogenous morselized bone adhibited by gelatin and genipin for repair of radial bone defect in rabbit 　　ZENG Rong, WU Shaoke, GUO Weitao, TAN Zhi, HU Zibin (Department of Orthopaedics, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524023, China) 　　Abstract: Objective To study the efficacy of autogenous morselized bone with gelatin and genipin for repair of radial bone defect in rabbit. Methods The segmental bone defects of bilateral radiuses were created in 24 New Zealand white rabbits. These rabbits were divided into 4 groups: group A received no implants, while group B, group C and group D were grafted with gelatin and genipin, 400 mg autogenous morselized bone, and 200 mg autogenous morselized bone with gelatin and genipin, respectively. The bone repair was assessed by gross specimen examination, Xray and histopathology at 2, 4 and 8 weeks. Results The bone defect repair was absent in group A and B, but excellent in group C and D. Position of morseliazed bone, bone fusion, new bone formation and bone moulding in group D were superior to those in group C.Conclusion Addition of gelatin and genipin in autogenous morselized bone can improve the repair of bone defect. 　　Key words: autogenous morselized bone; gelatin; genipin; bone defect 　　骨骼在损伤后有一定的自我修复能力，但广泛的骨缺损常常需要借助外科手段进行修复处理，准确的复位、有效的固定和充分的植骨是治疗的关键，其中自体骨移植应用广泛、疗效确切，被认为是骨缺损植骨的金标准[1]。自体颗粒骨移植治疗骨缺损是近年来出现的新的骨移植方式，颗粒骨主要应用于髋关节翻修时髋臼、股骨缺损的修复[2]，术后效果良好，其优点日益受到重视。但是其存在着结构松散、不易塑形、易移位、强度差等缺点。本实验拟利用明胶、京尼平粘附自体颗粒骨来检测其骨修复