用猪源生物材料骨进行犬骨性胸壁重建的可行性及-第三军医大学学报.doc

猪源生物型人工骨进行胸壁重建可行性及疗效的实验研究 彭秀凡1, 乔贵宾1,曾伟生1,唐 勇1,廖 明1，蒋仁超1,张 伟2 （510010 广州，广州军区广州总医院胸外科1；400038 重庆，第三军医大学西南医院胸心外科2） [摘要] 目的 探讨用猪源生物材料骨进行骨性胸壁修复重建的方法及疗效 方法 对6只中国杂种犬进行右侧开胸，切除第5～7肋及肋间肌，胸壁缺损9 cm×8cm，用人工骨替移植替代第5、6肋。术后1周、1个月、3个月、6个月、1年分别进行X线照片检查，观察人工骨有无发生移位、脱落、变形及植入骨溶解变薄。术后6个月及1年各解剖2只动物，分别进行大体检查，观察人工骨与犬自体骨连接处有无骨痂形成，对位、对线是否良好,犬胸壁内外表面弧度与犬胸壁是否一致；进行组织学检查，观察植入骨与犬自身骨交界处组织结构及植入骨周围有无排异反应。余下2只进行长期观察，以预测人工骨长期置入体内的可能性及转归。结果 6例动物全部长期存活，X线照片检查见人工骨无移位、脱落、变形及植入骨溶解变薄等情况发生。大体观察见犬骨性胸壁内外表面塑形良好，人工骨与犬自体骨连接处有明显的骨组织及软骨组织和明显骨痂形成，移植骨对位、对线均良好；组织学观察植入骨与犬自身骨交界处由骨组织和软骨组织组成，外层为骨膜组织，有成骨细胞和破骨细胞存在，未见炎细胞浸润等排异反应,移植骨中段为纤维结缔组织包绕，内有新生血管形成。 结论 猪源生物型人工肋骨是一种优质骨性胸壁重建材料，置入机体后具有逐渐溶解破坏并向自体骨转化倾向。 [关键词] 生物材料; 人工肋骨；胸壁缺损；重建 [中图法分类号] [文献标志码] A Feasibility and therapeutic effect of porcine-derived arti?cial bone in reconstruction of chest wall in dogs Peng Xiufan1, Qiao Guibin1, Zeng Weisheng1, Tang Yong1, Liao Ming1, Jiang Renchao1, Zhang Wei2 (1Department of Chest Surgery, General Hospital of Guangzhou Military Conmand, Guangzhou, Guangdong Province, 510010; 2Department of Cardiothoracic Surgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective To explore the method and efficacy of chest wall reconstruction by using porcine-derived arti?cial bone. Methods Through a right extrapleural thoracotomy, a chest-wall defect of 9 cm × 8 cm was created by the resection of 5 to 7 ribs and intercostal muscles in 6 Chinses mongrel dogs. Subsequently, neoplasty of chest wall was proceeded using biomaterial. The displaced, curvature, breakage and thickening of the arti?cial bone was evaluated by X-ray sonography at 5 postoperative time points (1 week, 1 , 3 and 6 months, and 1 year after operation). Gross examination was performed at 6 months and 1 year after operation to observe the callus formation, ossification, osteolysis. moulding of rib cage and surface shaping of the skeleton of thorax to evaluate the biological property of i