CAJ | 학술논문

背景:实验证实,低强度脉冲超声有促进骨折愈合的作用.但低强度脉冲超声对骨折愈合早期骨质再生成熟的影响及其相关的作用机制仍不十分清楚.目的;创新性提出低强度脉冲超声能够在兔胫骨骨延长动物模型牵拉成骨早期骨再生成熟中发挥正效效应的理论假设,并期望以超声干预与不干预进行对照比较予以验证. 方法:36只成年健康新西兰兔随机数字表法分为超声治疗组和对照组,每组18只.所有动物均行胫骨中段截骨,以Orthofix M103型迷你外固定架延长器固定,术后7 d以0.5 mm/12 h延长10 d,总延长长度为10 mm,超声治疗组在延长完成后以低强度脉冲超声骨折治疗仪治疗,20 min/d,1次/d,对照组不给予低强度脉冲超声治疗.治疗4,8,12周后,X射线评定胫骨骨折断端愈合程度,采用Image J图像分析软件分析计算骨痂生成率;延长区新骨作苏木精-伊红染色、Masson三色染色、VG染色后光镜下组织学分析,并在显微镜下测新骨占总骨痂的面积.结果与结论:36只兔均进入结果分析.治疗4周后对照组仅见外骨痂连接形成骨桥,骨痂区密度低,还可见部分骨痂缺如:超声治疗组骨早期再生成熟优于对照组,表现在两断端骨痂影密度增高,数量增多,骨痂影由两端向中央生长,被密度高的骨痂取代,外骨痂已开始被吸收,骨痂充满延长区,密度增高增粗,骨折处皮质骨密度接近正常皮质骨,骨痂生成率明显提高(P＜0.05),与8,12周无差异.组织学分析显示,超声治疗组治疗4,8,12周时新骨形成早于对照组,治疗4周新骨占总骨痂面积的百分比大于对照组,治疗8,12周后两组新骨占总骨痂面积的百分比无差别.提示低强度脉冲超声可促进新骨形成,增加骨痂面积,在兔胫骨骨延长动物模型牵拉成骨后的骨再生成熟中有促进作用.
배경:실험증실,저강도맥충초성유촉진골절유합적작용.단저강도맥충초성대골절유합조기골질재생성숙적영향급기상관적작용궤제잉불십분청초.목적;창신성제출저강도맥충초성능구재토경골골연장동물모형견랍성골조기골재생성숙중발휘정효효응적이론가설,병기망이초성간예여불간예진행대조비교여이험증. 방법:36지성년건강신서란토수궤수자표법분위초성치료조화대조조,매조18지.소유동물균행경골중단절골,이Orthofix M103형미니외고정가연장기고정,술후7 d이0.5 mm/12 h연장10 d,총연장장도위10 mm,초성치료조재연장완성후이저강도맥충초성골절치료의치료,20 min/d,1차/d,대조조불급여저강도맥충초성치료.치료4,8,12주후,X사선평정경골골절단단유합정도,채용Image J도상분석연건분석계산골가생성솔;연장구신골작소목정-이홍염색、Masson삼색염색、VG염색후광경하조직학분석,병재현미경하측신골점총골가적면적.결과여결론:36지토균진입결과분석.치료4주후대조조부견외골가련접형성골교,골가구밀도저,환가견부분골가결여:초성치료조골조기재생성숙우우대조조,표현재량단단골가영밀도증고,수량증다,골가영유량단향중앙생장,피밀도고적골가취대,외골가이개시피흡수,골가충만연장구,밀도증고증조,골절처피질골밀도접근정상피질골,골가생성솔명현제고(P＜0.05),여8,12주무차이.조직학분석현시,초성치료조치료4,8,12주시신골형성조우대조조,치료4주신골점총골가면적적백분비대우대조조,치료8,12주후량조신골점총골가면적적백분비무차별.제시저강도맥충초성가촉진신골형성,증가골가면적,재토경골골연장동물모형견랍성골후적골재생성숙중유촉진작용.
BACKGROUND: Experiments has demonstrated that low-intensity pulse ultrasound stimulations(LIPUS) can accelerate bone healing. However, Its affect mechanisms on maturation of regenerated bone remain unclear.OBJECTIVE: The hypothesis that LIPUS has positive effect on maturation of regenerate bone was put forward creatively, and wants to vedfy the hypothesis by compare the difference between LIPUS intervention and no intervention.METHODS: Thlrty-six adult, healthy, New Zealand White rabbits were randomly assigned to LIPUS treatment group and control.group, with 18 animals in each group.All animals were undergone mid-diaphyeaal tibia ostactomy and were immobilized in Orthofix M103 Mini lengtheners. After a eaven-day latency period, gradual distraction of 0.5 mm per twelve hours for 10 days to produce 10 mm distraction. A 4-weeks course of LIPUS treatment was applled over the distraction site for twenty minutes daily starting immediately after the completion of distraction. At weeks 4, 8, 12 after distraction, the bone healing was evaluated by X-ray film, and total mineralized areas were measured by Image J software. The newly formed bone In the lerigthening field was harvested and stained with haematoxylin-eosin, Masson's tdchroma end VG. Thearaas of newly formed bone were measured to calculate a percentage of the total callus area.RESULTS AND CONCLUSION: Thirty-six rabbits ware included in the final analysis, At week 4 after distraction, the maturation of newly formed bone in LIPUS treatment group appeared eadier than that in the control groups. The bona callus image presented in the marginal and center region of experimental defect, increased greatly and had higher density until filled of the lengthening fields. Many bone-like masses appeared in the newly formed tissues and the tissues surrounding the bone granules partially changed Into bone-like tissues, and the rate of callus production was increased (P ＜ 0.05). There was no significant difference between two groups at weeks 8 and 12 after distraction. Histological results showed that that new bone formation of the LIPUS group was earlier than the control group at weeks 4, 8, and 12 after distraction. The percentage of new bona on total callus area of the LIPUS group was greater than that of the control group at weak 4, but there was no obvious difference at weeks 8 and 12 after distraction. LIPUS accelerates new bone formation, increases the size of the distraction callus, exhibits highly effective in achieving maturation of bone in the animal modal with distraction osteogenesis.