CAJ | 학술논문

目的比较不同强度脉冲压力刺激对兔桡骨缺损修复的影响,为选取合适的压力刺激强度提供实验依据.方法取新西兰大白兔32只,构建5 mm桡骨缺损模型,随机分为4组(n=8):对照组术后正常喂养,不进行体外脉冲压力刺激;实验组于术后第4天分别给予不同强度的体外脉冲压力刺激持续至术后4周,1次/d,30 min/次,脉冲频率为15 Hz,并按照压力强度分为:5～7 kPa组,8 ～ 10 kPa组,11 ～13 kPa组.术后4周取材行标本大体观察、X线摄片和组织学观察以评价缺损修复情况. 结果术后4周标本大体观察:8 ～ 10 kPa组桡骨缺损处新生骨痂较其他3组明显偏多.术后4周X线片示4组骨缺损区均被大量高密度影填充,8 ～ 10 kPa组已基本形成完全骨性连接,其他3组骨缺损区仍可见较多低密度间隙.术后2、4周X线片.dicom原始数据分析显示8～ 10 kPa组骨缺损区X线灰度值最高,与其他3组比较差异有统计学意义(P＜0.05).术后4周Lane-Sandhu X射线评分8 ～ 10 kPa组最高,与其他3组比较差异有统计学意义(P＜0.05).术后4周Van Gieson染色结果显示:8 ～ 10 kPa组骨缺损区已有大量新生小梁骨完全填充,骨缺损两断端已基本形成完全骨性连接,其他3组骨缺损区有较多新生骨,其间尚存在许多纤维软骨团,骨缺损两断端未形成完全骨性连接. 结论体外脉冲压力在8 ～10 kPa范围内对骨缺损修复有明显的促进作用.
목적 비교불동강도맥충압력자격대토뇨골결손수복적영향,위선취합괄적압력자격강도제공실험의거.방법 취신서란대백토32지,구건5 mm뇨골결손모형,수궤분위4조(n=8):대조조술후정상위양,불진행체외맥충압력자격;실험조우술후제4천분별급여불동강도적체외맥충압력자격지속지술후4주,1차/d,30 min/차,맥충빈솔위15 Hz,병안조압력강도분위:5～7 kPa조,8 ～ 10 kPa조,11 ～13 kPa조.술후4주취재행표본대체관찰、X선섭편화조직학관찰이평개결손수복정황. 결과 술후4주표본대체관찰:8 ～ 10 kPa조뇨골결손처신생골가교기타3조명현편다.술후4주X선편시4조골결손구균피대량고밀도영전충,8 ～ 10 kPa조이기본형성완전골성련접,기타3조골결손구잉가견교다저밀도간극.술후2、4주X선편.dicom원시수거분석현시8～ 10 kPa조골결손구X선회도치최고,여기타3조비교차이유통계학의의(P＜0.05).술후4주Lane-Sandhu X사선평분8 ～ 10 kPa조최고,여기타3조비교차이유통계학의의(P＜0.05).술후4주Van Gieson염색결과현시:8 ～ 10 kPa조골결손구이유대량신생소량골완전전충,골결손량단단이기본형성완전골성련접,기타3조골결손구유교다신생골,기간상존재허다섬유연골단,골결손량단단미형성완전골성련접. 결론 체외맥충압력재8 ～10 kPa범위내대골결손수복유명현적촉진작용.
Objective To determine an appropriate intensity of pulsating pressure by comparing the stimulation effects of pulsating pressures of different intensities on the repair of rabbit radial defects.Methods Animal models of radial defect of 5 mm in length,which had been created in a total of 32 New Zealand rabbits,were randomized into 4 groups (n =8).The defects were repaired naturally in the control group (group A) while the other 3 experiment groups received stimulation of pulsating pressures of different intensities which started on the 4th day after surgery and continued every day for 4 weeks.The stimulation lasted 30 minutes each time and the frequency of pulsating pressure was 15 Hz.The 3 experimental groups were divided according to the intensities of pulsating pressure:5 to 7 kPa (group B),8 to 10 kPa (group C) and 11 to 13 kPa (group D).New bone formation in the 4 groups was evaluated by gross observation,X-ray radiography and Van Gieson staining at 4 weeks after surgery.Results By gross observation of the specimens,there was more new bony callus in the defects in group C than in the other 3 groups.X-ray radiography showed the bone defects in each group were filled with massive high-density shadow; both ends of the bone defects in group C were almost connected completely by the newly formed bone while quite a number of low-density gaps were observed in the defect area in the other 3 groups.The mean Lane-Sandhu X-ray score was the highest in group C,significantly higher than those in the other 3 groups (P ＜ 0.05).Analysis of the X-ray grayscale values of.dicom data showed that the X-ray grayscale value in group C was significantly higher than those in the other 3 groups (P ＜ 0.05).Van Gieson staining observed that the defects in group C were filled with a large amount of newly-formed trabecular bone and both ends of bone defects were almost connected completely by the trabecular bone,but that although a large amount of new bone was observed in the defects in the other 3 groups,there were still clusters of fibrous cartilage and both ends of the bone defects were not fully connected.Conclusion Stimulation of pulsating pressure in vitro at an intensity of 8 to 10 KPa can significantly promote the repair of rabbit radial defects.