成为骨科临床的常见疾病.docVIP

感染性兔胫骨游离后再血管化的病理学观察 初霞1、周明武2、张威2 中国人民解放军第153中心医院病理科1、手外科2，河南郑州，450042 摘要：目的 通过对异位移植的感染性胫骨的镜下病理学观察，探讨其异位再血管化的可能性，为清创后大块骨缺损的修复提供新的思路。方法 制备成功的兔骨髓炎骨感染模型，再截取其感染的游离胫骨一段，将它移植于股内侧肌肌瓣下，行墨汁灌注、HE组织切片及CD34免疫组化染色，观察其血管化进程及骨组织的生长情况。结果 术后4周、6周和8周随着游离胫骨骨组织表面软组织连接的增加，墨染范围逐渐扩大，直至全段游离骨，哈弗管的血管化从近髓腔开始直至骨表面，呈离心性发展，随着哈弗管的血管化，其周骨陷窝内也渐出现骨细胞，哈弗管内血液充盈越显著，其周围骨细胞核越肥胖，同时随着血管的增生，髓腔内纤维化越来越显著，至术后6周出现胶原化，到8周可见成骨细胞。结论 感染骨经灭菌处理后，移植于血运丰富的组织内能够完成异位血管化的过程。这为清创后大块骨缺损的修复奠定基础。 关键词：兔，感染性胫骨，再血管化，病理学 中图分类号：R602 The pathology observation of revascularization in the Infected rabbit tibia after dissociation Chu Xia1，Zhou Mingwu2，Zhang Wei2 Department of Pathology1，Hand Surgery2，the 153rd central hospital of PLA in Jinan Military Region，Zhengzhou，Henan，China，450042 Abstract: Objective We observed the pathology of infected tibial in ectopic transplantation in order to explore the feasibility of its ectopic revascularization, and to provide a new way for the repair of massive bone defect after debridement. Method We prepared the rabbit osteomyelitis model. Then the infected tibial were dissociate, and ported to the vastus medialis muscle flap. It were perfused with Chinese ink, HE tissue slice and CD34 immunohistochemistry staining. We observed the growth of the vascularization and bone tissue. Results During 4 weeks, 6 weeks to 8 weeks after operation, ink stained expands gradually along with the soft tissue increase of free bone surface, until the entire bone. The growth of vascular in Haversian canal was from marrow cavity to the bone surface. It was a centrifugal development. The more fuller the blood of vascular was in Haversian canal, the more obeser the nucleus of bone cell was surrounding it. As the vascular growed in number, the fibrosis was arisen, and became collagen at 6 weeks after surgery. Osteoblasts were observed at 8 weeks. Conclusion The infected bone sterilized was transplanted to plentiful blood tissue. Its revascularization process can be completed. This lays the foundation for the