摘要
目的:观察自固化磷酸钙复合骨髓治疗骨缺损的疗效。方法:动物实验于1999-07/2000-01在桂林医学院骨科实验室(省级)完成。选用15只实验兔制备双侧桡骨的骨缺损模型,一侧骨缺损用自固化磷酸钙与骨髓复合移植修复,作为实验侧;对侧桡骨骨缺损不作处理,作为对照侧。术后第1,2,4,6,8周摄双侧桡骨X射线平片;术后第2,4,8周麻醉后各处死5只兔子,切取桡骨,制备切片,苏木精-伊红染色,光镜观察其组织学改变。临床实验:2000-03/2004-03对桂林医学院骨科收治的18例良性骨肿瘤患者行病灶刮除,采用自固化磷酸钙复合骨髓填充修复骨缺损。结果:15只兔子和18例患者数据均进入结果分析。动物实验结果:①X射线平片:实验侧:2周时骨缺损处两骨端及自固化磷酸钙周围出现明显的不透光影;4周近骨断端自固化磷酸钙与新生骨开始愈接;8周时自固化磷酸钙与新生骨完全愈接,骨缺损间隙消失,获骨性愈合。对照侧至第4周骨缺损的两骨端才出现少许淡染骨痂影;6￣8周见骨端硬化,骨缺损区无骨连接。②组织学检查:对照侧:4周时,缺损区出现明显结缔组织增生,少量软骨内成骨,8周时缺损区增生结缔组织更为致密、玻璃样变。实验侧:2￣4周,有小血管及骨膜组织增生,膜内成骨;8周时大量新生骨小梁出现,自固化磷酸钙与组织界面处有自固化磷酸钙降解现象。临床应用结果:18例均获得随访,随访时间6￣40个月,平均18个月。所有患者均未出现过敏或毒性反应,钙磷代谢正常。术后X射线片示骨缺损区充填良好。随访时发现,骨缺损区逐步出现自固化磷酸钙的降解和新骨替代现象。结论:自固化磷酸钙与骨髓复合移植适用于非负重或低负重区骨缺损的修复。
AIM： To observe the curative effect of calcium phosphate cement and bone marrow on bone defects. METHODS： The experiment was performed in the laboratory of Department of Orthopaedics, Affiliated Hospital of Guilin Medical College from July 1999 to January 2000. Totally 15 experimental rabbits were selected to establish models of bilateral bone defect in the radius of rabbits. One side defect was repaired with calcium phosphate cement and bone marrow as experimental side. The other side was aimed as control. The X-ray examinations were done at weeks 1, 2, 4, 6 and 8 after operation. Rabbits were executed after 2, 4, 8-week surgery with 5 each time. Radiuses were cut and made into sections. Specimens were observed under optical microscope for its histological changes after haematoxylin-eosin （HE） staining. Clinical experiment： From March 2000 to March 2004, focus of infection was removed in 18 cases of benign bone neoplasm in the Department of Orthopaedics, Affiliated Hospital of Guilin Medical College, and bone defects were repaired with calcium phosphate cement and bone marrow. RESULTS： A total of 15 rabbits and 18 patients were involved in the result analysis. Animal experiment： ~X-ray plain film： Experimental side： obvious opacity occurred around calcium phosphate cement and both ends of bone defects in 2 weeks, calcium phosphate cement at the near-end of bone detect connected with neonatal bone in 4 weeks; calcium phosphate cement completely connected with neonatal bone with interspace disappeared and bone union was observed in 8 weeks. Control side： few light-stained osteotylus shadow occurred at both ends of bone defect until 4 weeks. Ossification occurred at the ends in 6 to 8 weeks but without osseous connection in bone defect area. （~）Histological examination： Control side： many connective tissue hyperplasia occurred and only few osteogenesis in cartilage was found in 4 weeks. Proliferative connective tissue became more compact and hyaline degeneration appeared in 8 weeks. Experimental side： small vessels, periosteum hyperplasia and membrane bone formation could be seen in 2 to 4 weeks, and many neonatal bone trabecula appeared and calcium phosphate cement degradation could be seen at the interface between calcium phosphate cement and tissue as well in 8 weeks. Clinical application： Totally 18 cases were followed up for 6-40 months, averegely 18 months. No hypersensitiveness or toxic reaction was found in these patients. Calcium-phosphate metabolism was normal. In X-ray plain after operation, bone defect was healed, and calcium phosphate cement degradation and neonatal bone recovery were appeared during follow up. CONCLUSION： Calcium phosphate cement and bone marrow are applicable in the low-or non-weight-loading site of the extremities.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第34期6860-6862,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
