带血管骨膜和同种脱钙骨基质联合移植与自体骨移植修复骨缺损的比较.docVIP

带血管骨膜和同种脱钙骨基质联合移植与自体骨移植修复骨缺损的比较研究 更新日期：2010-07-03 冀振亮　蒋祖言　王爱民　王民刚　李叶君 　　【摘要】　目的　了解带血管骨膜(VP)和同种脱钙骨基质(DBM)联合移植替代自体骨移植修复大段骨缺损的可能性。方法　以兔桡骨中央25mm的大段骨缺损为模型,通过X线观察、X线平片骨缺损修复Lane评分、组织学观察、骨组织形态计量分析和生物力学测试,比较术后4,8,16周时VP+DBM联合移植与自体骨移植修复骨缺损的效果。结果　术后4周VP+DBM联合移植及自体骨移植均已较好地完成了缺损的修复,而前者的Lane评分、皮质骨密度、力学抗扭刚度均显著高于后者(P0.05)。但术后8,16周时两者之间已无显著性差异(P0.05)。结论　VP+DBM联合移植早期修复兔桡骨大段骨缺损的效果好于自体骨移植。后期两种方法修复效果基本一致。VP+DBM联合移植后,两者之间建立了相互协同、相互促进的关系。【关键词】　带血管骨膜　同种脱钙骨基质　自体骨　骨缺损　移植 Comparative Study of Fresh Autogenic Bone and Vascularized Periostium Associated with Demineralized Bone Matrix Graft on Healing Large Segmental Radius Defect in Rabbits　　JI Zhen-liang, JIANG Zu-yan, WANG Ai-min, et al. Dept. of Orthopaedics, 256th Hospital of PLA, Zhengding 050800 　　【Abstract】　Aim　To explore the possibility of vascularized periostium associated with demineralized bone matrix (VP+DBM) graft to replace fresh autogenic bone graft to repair large segmental bone defect. Methods　The effect of fresh autogenic bone, and VP+DBM graft on the healing of a 25mm diaphyseal defect in 102 radii were studied respectively on 51 rabbits. The results were evaluated by X-ray examination, Lanes Radiographic Scoring, histological and histomorphometrical examination, and torsional load testing. Results　Defects filled with autogenic fresh bone or VP+DBM showed new bone formation of good quality. The Lanes score, the cortical bone density and the stiffness of the radia in the VP+DBM group were more significant than that in the fresh autogenic bone group 4 weeks postoperation (P0.05), but no statistical difference 8 or 16 weeks postoperation (P0.01). Conclusion　The effect of VP+DBM graft is better than that of autogenic bone graft in the early healing stage of the radius defects in rabbits, but in the late stage their effects have no significant difference. The VP and DBM combination therapy can promote the healing of long bone defect rapidly and reliably. It is believed that VP and DBM can be combined and can stimulate with eac