摘要
目的观察自体骨瓣皮下保存及早期回植行颅骨成型术后骨瓣的骨质生物学变化。方法利用新西兰大白兔随机分为正常、假手术和手术组，制作去骨瓣减压及皮下自体骨瓣保存模型，并于保存2周的自体骨瓣回植行颅骨成型术。分别于不同时间点测定骨瓣的骨钙含量，运用组织化学染色及扫描电子显微镜观察骨瓣组织学及生物结构的改变。结果正常颅骨及皮下保存骨瓣的骨钙含量分别为（935．15±166．36）ug/g（正常组）、（847．40±126．97）ug/g（1周组）、（766．55±126．89）ug／g（2周组）、（603．53±37．10）ug／g（4周组）、（444．68±48．05）ug／g（8周组）；骨瓣回植颅骨成型术后的骨钙含量分别为（628．53±47．16）ug/g（回植后2周组）、（691．55±50．61）ug/g（回植后4周组）、（835．89±94．75）ug／g（回植后8周组）。皮下保存的自体骨瓣逐渐被纤维组织包裹，骨髓腔破坏，陷窝细胞死亡，但骨小梁存在；骨瓣回植成型术血运逐步建立，部分死骨复活。结论自然状态下皮下保存自体骨瓣回植的最佳期限应在4周以内。早期特别是超早期施行皮下保存自体骨瓣颅骨成型术后，骨瓣的生物化学指标可以达到正常颅骨的水平。
Objective To investigate the biological changes of autogenous skull flap after subcutaneous preservation and early cranioplasty. Methods The New Zealand white rabbits were divided into 3 groups ： normal controls, sham-operated controls and operated groups, and the models of skull flap-removed decompression and subcutaneous preservation were established. The autogenous camioplasty was done two weeks after subcutaneous preservation. The calcium content of skull flap was determinated at different time points, and histological and bio-structural changes were observed by using immunohistochemistry stain and electron microscopy scanning. Results The calcium contents in normal and subcutaneously preserved skull flaps were （ 935.15 ± 166.36 ） （normal） , （ 847.40 ± 126.97 ） （ at first week） , （ 766.55 ± 126.89 ） （ at 2nd week）, （603.53 ± 37.10） （ at 4th week） , and （444.68 ± 48.05 ） ug/g （ at 8th week） respectively. The calcium contents in the skull flaps after camioplaty were （628.53 ± 47.16） （at 2nd week） , （ 691.55 ± 50.61 ） （ at 4th week） , and （ 835.89 ± 94.75 ） ug/g （ at 8th week） respectively. The skull flaps subcutaneously preserved were wrapped up by fibrous tissue gradually, the marrow cavity was destroyed,and the lacunar cells in the osseous lamella were dead, but the bone trabecula still existed. After the transplantation of the autogenous skull flap, blood vessels were grown into the bone edges as the time went on, and part of the dead bone reactivated. Conclusion The autogenous skull flap cranioplasy should be done at the 4th week after subcutaneous preservation. If the autogenous skull flap cranioplasy could be done early, the biochemical characters of the skull flaps which preserved subcutaneously could achieve almost normal level.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2009年第9期1122-1124,I0001,共4页
Chinese Journal of Experimental Surgery
基金
河北省科学技术厅基金资助项目（07276101D-80）
关键词
自体骨瓣
颅骨成型术
骨质生物学
Autogenous bone flap
Cranial bone forming operation
Bone biology
