CAJ | 학술논문

目的探讨感染骨段灭菌后异位再血管化的可行性.方法 60只中国白兔随机分为两组.实验组:制备胫骨感染模型,模型建立后,截取1.5 cm感染胫骨,活力碘灭菌处理;胫骨残端扩创,小腿钢板短缩内固定.将灭菌后的骨段置于同侧隐动脉滋养的股内侧肌与股直肌间隙并固定.对照组:在相同部位截取等长健康兔胫骨,其余步骤同实验组.术后4、6、8周行解剖学观察,墨汁动脉灌注观察骨表面墨染,病理切片观察骨段内血管管腔数量,并行统计学处理.结果术后4周:骨表面形成一薄层结缔组织膜,灌注可见骨表面散在点片状墨染区域,病理切片见血管管腔数量少,正常骨、对照组、实验组血管管腔计数分别为(11.10 ±2.26)、(10.20 ±2.10)、(10.01±1.91)个/视野,差异无统计学意义(P＞0.05).6周:两组骨均可见表面结缔组织膜增厚,骨表面墨染面积增大,分布不均匀,病理切片可见大量血管管腔.管腔数量对照组[(21.70 ±1.77)个/视野]高于实验组[(17.60 ±2.72)个/视野],差异有统计学意义(P＜0.05).8周:两组骨表面均形成较厚结缔组织膜,墨染范围扩散至全骨.病理切片见血管管腔密集分布,对照组、实验组血管管腔计数分别为(26.40±1.96)、(24.60±2.91)个/视野,两组差异无统计学意义(P＞0.05),6周及8周时,两组血管管腔计数均多于正常骨(P＜0.05).同组内管腔数量,随着时间的延长而增加(P＜0.05).结论兔感染骨段经活力碘浸泡处理,能够达到理想的灭菌效果.灭菌后的感染骨段置于有知名血管的血供丰富的组织内,8周可完成再血管化过程,重建骨血液循环,为二期回植修复骨缺损创造条件.
목적 탐토감염골단멸균후이위재혈관화적가행성.방법 60지중국백토수궤분위량조.실험조:제비경골감염모형,모형건립후,절취1.5 cm감염경골,활력전멸균처리;경골잔단확창,소퇴강판단축내고정.장멸균후적골단치우동측은동맥자양적고내측기여고직기간극병고정.대조조:재상동부위절취등장건강토경골,기여보취동실험조.술후4、6、8주행해부학관찰,묵즙동맥관주관찰골표면묵염,병리절편관찰골단내혈관관강수량,병행통계학처리.결과 술후4주:골표면형성일박층결체조직막,관주가견골표면산재점편상묵염구역,병리절편견혈관관강수량소,정상골、대조조、실험조혈관관강계수분별위(11.10 ±2.26)、(10.20 ±2.10)、(10.01±1.91)개/시야,차이무통계학의의(P＞0.05).6주:량조골균가견표면결체조직막증후,골표면묵염면적증대,분포불균균,병리절편가견대량혈관관강.관강수량대조조[(21.70 ±1.77)개/시야]고우실험조[(17.60 ±2.72)개/시야],차이유통계학의의(P＜0.05).8주:량조골표면균형성교후결체조직막,묵염범위확산지전골.병리절편견혈관관강밀집분포,대조조、실험조혈관관강계수분별위(26.40±1.96)、(24.60±2.91)개/시야,량조차이무통계학의의(P＞0.05),6주급8주시,량조혈관관강계수균다우정상골(P＜0.05).동조내관강수량,수착시간적연장이증가(P＜0.05).결론 토감염골단경활력전침포처리,능구체도이상적멸균효과.멸균후적감염골단치우유지명혈관적혈공봉부적조직내,8주가완성재혈관화과정,중건골혈액순배,위이기회식수복골결손창조조건.
Objective Investigating the possibility of revascularization about sterilized infectious bone by ectopic transplantation.Methods 60 rabbits were divided into two groups randomly.Experimental group:After established animal model of infected bone,1.5 cm infectious tibias of the successful animal models were cut out and soaked in iodophor 30 min.The stumps of infectious tibias were debrided and fixed with steel plate.The sterilized tibias were transplant and fixed near the ipsilateral medial vastus and rectus femoris muscle.Control group:1.5 cm normal tibias of healthy rabbits were deal with the same methods as experimental group.At 4 weeks,6 weeks and 8 weeks after operation,the bones by ectopic transplantation of two groups were obtained and observed.The areas of ink stained on the bone surrace by ink perfusion.The numbers of microvessel in bone were counted by pathological section.Then those experimental data were processed and statistic analyzed.Results Four weeks after operation:A thin layer connective tissue membranes on the bone surface were found.Some small amount of ink stained areas on the bone surfaces were scattered.For vascular bureaucratic counts of normal bone,the control group,the experimental group,their (mean ± standard deviation) s were (11.10 ±2.26)/field,(10.20 ±2.10)/field,(10.01 ± 1.91)/field,there was no statistically significant (P ＞ 0.05).Six weeks after operation:there were some thick connective tissue membranes on the graft bone surface.Ink stained areas were spread and uneven distribution.Lumen number in the control group [(21.70 ± 1.77)/field] higher than that of the experimental group [(17.60 ± 2.72)/field],the difference was statistically significant (P ＜ 0.05).Eight weeks after operation:Compared with those formers,there were thicker connective tissue membranes and dense deployment of vessels on the graft bone.For vascular bureaucratic counts of the control group,the experimental group,their (mean ± standard deviation) s were (26.40 ± 1.96)/field,(24.60 ± 2.91)/field,no statistically significant difference between the two groups (P ＞ 0.05).Meanwhile,the counts of new vessels in two groups were increased with the prolonging time (P ＜ 0.05).Conclusion The infectious bone of rabbits can be sterilized by soaked in iodophor.The sterilized bone graft into the tis-sue which has known vessels and a abundant blood supply.After 6 or 8 weeks,the revascularization can be completed and rebuilt the blood circulation of graft bones.Those could create the favorable conditions for the infectious bone replantation to repair bone defetcts.