CAJ | 학술논문

目的探讨大段感染骨煮沸后异位活化的可行性.方法将160只健康6个月龄中国白兔随机分为实验组、对照组各80只.实验组:首先制备兔胫骨感染模型,然后截取2.0cm长感染胫骨,经煮沸灭菌后,异位于对侧大腿股直肌与股内侧肌间隙之隐动脉处,1.0克氏针固定于股骨上.对照组:在同一部位截取相同长度的无菌胫骨段经生理盐水浸泡后,余步骤同实验组.两组分别于术后各时间节点处死10只兔,通过大体标本观察及免疫组织化学染色法检测移植骨骨形态发生蛋白-2 (BMP-2)和Ⅰ型胶原蛋白生成量的灰度值,分析判断两组骨活化进程.结果自体正常骨异位后逐渐被结缔组织包裹,其表面出现大小不同的小凹,且逐渐增多,要快于煮沸骨相应进程.对照组BMP-2和Ⅰ型胶原蛋白的灰度值在术后10周达到峰值,分别为147.04±9.52、148.87±6.52,与实验组术后16周相应数值(145.08±6.59、147.25±5.49)比较,差异均无统计学意义(P＞0.05).结论兔自体正常骨异位于血供丰富的组织间隙内经过10周可转变为活化骨,要快于煮沸骨,而煮沸骨经过16周也完成活化过程.证实兔大段感染骨煮沸后异位活化的可行性.
목적 탐토대단감염골자비후이위활화적가행성.방법 장160지건강6개월령중국백토수궤분위실험조、대조조각80지.실험조:수선제비토경골감염모형,연후절취2.0cm장감염경골,경자비멸균후,이위우대측대퇴고직기여고내측기간극지은동맥처,1.0극씨침고정우고골상.대조조:재동일부위절취상동장도적무균경골단경생리염수침포후,여보취동실험조.량조분별우술후각시간절점처사10지토,통과대체표본관찰급면역조직화학염색법검측이식골골형태발생단백-2 (BMP-2)화Ⅰ형효원단백생성량적회도치,분석판단량조골활화진정.결과 자체정상골이위후축점피결체조직포과,기표면출현대소불동적소요,차축점증다,요쾌우자비골상응진정.대조조BMP-2화Ⅰ형효원단백적회도치재술후10주체도봉치,분별위147.04±9.52、148.87±6.52,여실험조술후16주상응수치(145.08±6.59、147.25±5.49)비교,차이균무통계학의의(P＞0.05).결론 토자체정상골이위우혈공봉부적조직간극내경과10주가전변위활화골,요쾌우자비골,이자비골경과16주야완성활화과정.증실토대단감염골자비후이위활화적가행성.
Objective To investigate the possibility of activation about long infectious bone after boiling by ectopic transplantation.Methods 160 healthy Chinese rabbits (6 months of age) were randomly divided into experimental group and control group with 80 rabbits per group.Experimental group:the rabbit tibia infection model was established first,and then 2.0 cm long infectious tibia was cut out and boiled which was ectopically implanted into the contralateral thigh rectus femoris and vastus medialis muscle gap of the rabbit around the saphenous artery by fastened to the femur by 1.0 Kirschner-wire.Control group:cut out the same part and length of sterile tibia treated with normal saline soak,another steps with the experimental group.The 10 rabbits from two groups respectively at all time nodes after surgery were put to death and bone activation process of two groups were analyzed by general observation of samples and immunohistochemical staining method to detect grey value of bone morphogenetic protein-2 (BMP-2) and collagen Ⅰ expression of the bone grafts.Results The autologous normal bone by ectopic transplantation was gradually wrapped in the fibrous connective tissue and its surface appeared small concaves of different sizes with gradually increasing,and these were faster than boiling bone process accordingly.10 weeks postoperatively,the gray values of BMP-2 and collagen Ⅰ of the control group peaked and were respectively (147.04±9.52,148.87 ± 6.52),which were compared with the corresponding numerical (145.08 ± 6.59,147.25 ± 5.49) of the experimental group 16 weeks postoperatively,with no statistically significant difference (P ＞ 0.05).Conclusion The rabbit autologous normal bone located in the organization gap of the rich blood supply needed 10 weeks into activated bone and was faster than boiling bone,and boiling bone also completed the activated process at the postoperative 16 weeks.The experiment confirmed the possibility of activation about long infectious bone of the rabbit after boiling by ectopic transplantation.