CAJ | 학술논문

目的通过对带蒂筋膜瓣在修复骨缺损时促非细胞型组织工程骨血管化及其对成骨作用影响的动态组织学观察,论证带蒂筋膜瓣具有较好的促血管化成骨作用.方法制作动物骨缺损模型及带蒂筋膜瓣,随机分为A、B、C、D四组,对照组：A组单纯植入非细胞型组织工程骨,B组为无蒂筋膜瓣包裹的非细胞型组织工程骨,C组为无蒂筋膜瓣包裹的复合VEGF非细胞型组织工程骨;实验组：D组带蒂筋膜瓣包裹的非细胞型组织工程骨.术后第4、8、12、16周进行骨缺损修复区组织学观察、再生血管图像计量分析、新生骨形态计量分析.结果术后第4、8、12、16周组织学观察,骨修复区新生骨的形成、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解,D组明显优于A、B、C三组.血管图像计量分析及骨形态计量分析显示,除第4周D、C两组比较差异无显著性（P〉0.05）,其余各时间段D组明显优于A、B、C三组,差异有显著性（P〈0.05）,且各组前后时间段比较差异亦有显著性（P〈0.05）.结论带蒂筋膜瓣早期具有明显的促血管化作用,并显著增强中后期的成骨作用,缩短骨修复时间.
목적통과대대체근막판재수복골결손시촉비세포형조직공정골혈관화급기대성골작용영향적동태조직학관찰,론증대체근막판구유교호적촉혈관화성골작용.방법제작동물골결손모형급대체근막판,수궤분위A、B、C、D사조,대조조：A조단순식입비세포형조직공정골,B조위무체근막판포과적비세포형조직공정골,C조위무체근막판포과적복합VEGF비세포형조직공정골;실험조：D조대체근막판포과적비세포형조직공정골.술후제4、8、12、16주진행골결손수복구조직학관찰、재생혈관도상계량분석、신생골형태계량분석.결과술후제4、8、12、16주조직학관찰,골수복구신생골적형성、골간결구적중소、골수강적재통、식입물적흡수강해,D조명현우우A、B、C삼조.혈관도상계량분석급골형태계량분석현시,제제4주D、C량조비교차이무현저성（P〉0.05）,기여각시간단D조명현우우A、B、C삼조,차이유현저성（P〈0.05）,차각조전후시간단비교차이역유현저성（P〈0.05）.결론대체근막판조기구유명현적촉혈관화작용,병현저증강중후기적성골작용,축단골수복시간.
Objective To demonstrate that pedicle fascial flap has a satisfactory vascularization osteogenesis by dynamic histological observation of effects of pedicle fascial flap on the vascularization of the uncellular tissue engineered bone and the osteogenesis in process of bone defect repairing.Methods Animal model and pedicle fascial flap was made and divided into four groups,Groups A,B,C and D randomly.Control groups were Group A with uncellular tissue engineering bone simply,Group B with uncellular tissue engineering bone packed by the fascial flap without pedicle and Group C with uncellular tissue engineering bone packed by the fascial flap without pedicle combing VEGF.The experimental group was Group D with uncellular tissue engineering bone packed by pedicle fascial flap.The histology observation,vessel image quantitive analysis and the bone morphology quantitive analysis were performed in the repair area of bone defect on the 4th,8th,12th and 16th weeks after operation.Results Group D was superior to Group A,B and C obviously in the formation of new bone in the repair area,the remodeling of diaphysis structure,the recanalization of medullary canal and the absorption and degradation of implant on the 4th,8th,12th and 16th week after operation.The vessel image quantitive analysis and bone morphology quantitive analysis indicated that Group D was superior to Group A,B and C obviously on each period and the difference had statistical Significance except on 4th week between Group D and Group C（P0.05）and the comparison between the former and the latter in each group also had statistical significance（P0.05）.Conclusion The pedicle fascial flap has obvious vascularization in the early stage and can enhance osteogenesis obviously in midanaphase and shorten the repair period.