CAJ | 학술논문

背景:低能鼍激光对骨折愈合有促进作用,能够加速骨折愈合,缩短骨折愈合时间,增强骨折愈合强度,对早期骨折愈合有较好的疗效.目的:评价不同波长低能量激光对早期骨折愈合的疗效.设计、时间及地点:随机对照动物实验,于2005-05/2006-05在韩国檀国大学医科大学激光中心完成.材料:60只9月龄的英国Hartley雌性豚鼠,体质量(300±30)g,随机分为632 nm,830 nm实验组各20只,对照组20只.方法:每只豚鼠左臀部肌肉内注射麻醉药,麻醉成功后,右侧股骨干中段用咬骨钳将其咬断并造成粉碎性骨折,再用1.4 mm克斯针经骨髓腔行内固定术.632 nm和830 nm波长半导体激光仪器分别用于两个实验组.低能量靠激光照射从术后48 h开始,在股骨干骨折区上方垂直照射,每两天1次,照射剂量同为100J/cm2,照射面积同为2.52cm2.最后46只豚鼠成活,其中对照组14只,632 nm和830 nm实验组各16只.主要观察指标:在第3,6周心脏注射处死豚鼠.提取股骨干标本,采用Modified Zorlu Scoring System评价骨折愈合情况,包括肉眼观察,影像学CR检查和组织学检查.结果:46只豚鼠均存活,大体观察观察和影像学CR检查结果显示:第3周,632 nm和830 nm实验组的骨痂形成速率均显著性高于对照组(P<0.01):830 nm实验组的骨痂形成量多于632 nm实验组(P>0.05).组织学检查结果显示:第3周,两个实验组造骨细胞的增生聚集显著性大于对照组(P<0.01).在第3,6周,632 nm和830 nm两个实验组之间虽然没有显著性差异,但是830 nm实验组造骨细胞的增生量高于632 nm实验组(P>0.05).结论:632 nm和830 nm照射波长治疗对早期骨折愈合均取得较好的效果,830 nm波长促进骨折的愈合效果好于632 nm波长.
배경:저능타격광대골절유합유촉진작용,능구가속골절유합,축단골절유합시간,증강골절유합강도,대조기골절유합유교호적료효.목적:평개불동파장저능량격광대조기골절유합적료효.설계、시간급지점:수궤대조동물실험,우2005-05/2006-05재한국단국대학의과대학격광중심완성.재료:60지9월령적영국Hartley자성돈서,체질량(300±30)g,수궤분위632 nm,830 nm실험조각20지,대조조20지.방법:매지돈서좌둔부기육내주사마취약,마취성공후,우측고골간중단용교골겸장기교단병조성분쇄성골절,재용1.4 mm극사침경골수강행내고정술.632 nm화830 nm파장반도체격광의기분별용우량개실험조.저능량고격광조사종술후48 h개시,재고골간골절구상방수직조사,매량천1차,조사제량동위100J/cm2,조사면적동위2.52cm2.최후46지돈서성활,기중대조조14지,632 nm화830 nm실험조각16지.주요관찰지표:재제3,6주심장주사처사돈서.제취고골간표본,채용Modified Zorlu Scoring System평개골절유합정황,포괄육안관찰,영상학CR검사화조직학검사.결과:46지돈서균존활,대체관찰관찰화영상학CR검사결과현시:제3주,632 nm화830 nm실험조적골가형성속솔균현저성고우대조조(P<0.01):830 nm실험조적골가형성량다우632 nm실험조(P>0.05).조직학검사결과현시:제3주,량개실험조조골세포적증생취집현저성대우대조조(P<0.01).재제3,6주,632 nm화830 nm량개실험조지간수연몰유현저성차이,단시830 nm실험조조골세포적증생량고우632 nm실험조(P>0.05).결론:632 nm화830 nm조사파장치료대조기골절유합균취득교호적효과,830 nm파장촉진골절적유합효과호우632 nm파장.
BACKGROUND: Low power laser irradiation has positive effects on fracture healing, including shortening the time of bone union and enhancement of bone formation. OBJECTIVE: To evaluate the effects of different wave lengths in low power laser on eedy fracture healing. DESIGN, TIME AND SETTING: Randomized, controlled, animal experiment. The study was performed at the Laser Center of Dankook University Medical Center between May 2005 and May 2006. MATERIALS: A total of 60 female English Hartley guinea pigs, 9 weeks old, weighing (300～30) g, were used for this experiment. They were randomly divided into three groups control, 632, and 830 nm groups (n=20). METHODS: The right femoral middle shaft fractures were made with a bone cutter and fixed with intramedullary nails (1.4 mm diameter K-wire). The frequencies of 632 nm and 830 nm semi-conductor laser machines were used. The laser irradiations were started 48 hours after operation vertically at the fracture sites and were applied every two days, at 100 J/cm<'2> of the same irradiation doses and 2.52 cm<'2> of the same irradiation areas in different irradiation groups. Finally, 46 guinea pigs survived, including 14 in control group, 16 in 632 nm group and 16 in 830 nm group. MAIN OUTCOME MEASURES: Guinea pigs were sacdficed at 3 and 6 weeks separately. The bone healing was assessed by the Modified Zorlu Scoring System, including gross, radiologic and histologic examinations. RESULTS: In the gross and radiologic findings, both 632 nm and 830 nm irradiation groups shown a significantly greater rate of callus formation at postoperatively 3 weeks compared to the control group (P< 0.01). Quantity of callus formation in 830 nm group was more than 632 nm group, but there was no significant difference (P > 0.05). The result of histological findings showed a significant increase of osteoblastic proliferation in two irradiation groups than the control group at 3 weeks postoperatively (P < 0.01). Enhancement of osteoblastic proliferation was more obvious in 830 nm group than in 632 nm group at 3 and 6 weeks, but there was no significant difference (P > 0.05).CONCLUSION: Both 632 nm and 830 nm wave lengths are considered to be optimal irradiation wave lengths for eady fracture healing. Moreover, 830 nm irradiation is better than 632 nm irradiation for eady fracture healing.