【作者】 余建平；

【导师】 苏云星；

【作者基本信息】 山西医科大学 ， 骨科学， 2008， 硕士

【摘要】 目的:初步探讨金葡液以纤维蛋白胶为载体修复大鼠骨缺损的可行性,避免金葡液局部注射的缺陷。材料和方法:制备纤维蛋白胶-金葡液复合物。将80只Wister大鼠随机分为四组,即实验组(20只)、对照组A(20只)、对照组B(20只)及空白组(20只)。在大鼠双侧顶骨各造成一个直径5mm的骨缺损,制备骨缺损动物模型。实验组:双侧颅顶骨缺损内均植入纤维蛋白胶-金葡液复合物;对照组A:双侧颅顶骨缺损内均单纯植入纤维蛋白胶;对照组B:双侧颅顶骨缺损内均在术后一周单纯注入金葡液(与实验组中所含金葡液的量相等);空白组不植入任何物质。另取5只大鼠不做任何处理作为正常颅骨组。术后4周,行大体观察、放射学观察;术后6周,行大体观察、放射学观察、组织学观察,在万能材料性试验机上行压凹试验,并与正常颅骨比较。结果:术后各组均无明显的免疫排斥反应。术后4,6周,放射学观察显示实验组缺损区的成骨面积百分比明显大于对照组A、B及空白组,四组组间比较差异均有统计学意义(P<0.01);术后6周,组织学观察显示,实验组骨缺损内可见纤维蛋白胶已完全吸收,缺损基本上骨性愈合,对照组A缺损内纤维蛋白胶已降解吸收,缺损边缘有大量新生骨质,空白组缺损边缘亦可见到少量新生骨质,其他部分为致密纤维结缔组织覆盖,对照组B缺损内新生骨的成骨量介于对照组与空白组之间;生物力学实验结果显示,实验组标本最大载荷高于对照组A、B,且低于正常颅骨组,四组组间比较差异均有统计学意义(P<0.05);对照组A、B最大应变位移明显高于实验组(P<0.05),且对照组A与对照组B最大应变位移接近,两组组间比较差异无统计学意义(P>0.05),而实验组最大应变位移与正常颅骨组接近,两组组间比较差异无统计学意义(P>0.05);实验组、正常颅骨组的载荷/应变比值明显高于对照组A、B,且实验组的载荷/应变比值明显低于正常颅骨组,对照组A的载荷/应变比值明显高于对照组B,四组组间比较差异均有统计学意义(P<0.05)。结论:金葡液以纤维蛋白胶为载体修复大鼠骨缺损是可行的,形成的复合物具有促进成骨的能力.更多还原

【Abstract】 Objective: To study the feasibility of fibrin sealant as carrier of staphy1ococcus aureus injection for repairing bone defects, and avoid the flaws of local injection of staphylococcus aureus injection.Methods: To preparation the complex of fibrin sealant and staphylococcus aureus injection. Eighty Wister rats were randomly divided into four groups: experimental group (n=20), control groupA(n=20), control groupB (n=20) and blank group (n=20). Two 5-mm diameter bone defects were created symmetrically on both sides of the cranial bone in rats. Rars were implanted with the complex of fibrin sealant and staphylococcus aureus injection in bilateral calvarial bone defect in experimental group; with fibrin sealant in control groupA; with staphylococcus aureus injection in control groupB after operation for 1 week (containing the same amount of staphylococcus aureus injection as the experimental group); while nothing was implanted in blank group; Another five rats without any treatment were regarded as normal skull group. After operation for 4 weeks, general observation, radiology observation were performed; after operation for 6 weeks, general observation, radiology observation, histological examination were performed, biomechanics were determined, and compared with normal skull.Results:After operation each group had no significant immune rejection. After operation for 4 and 6 weeks, radiology observation indicated that percentage of new bone forming area in experimental group was higher than in control groupA, B and blank group, and there was statistically significant difference between four groups(P<0.01). 6 weeks later, histological examination revealed that fibrin sealant had been completely absorbed in experimental group and bone defect basically healed, but in control groupA, fibrin sealant had been completely degraded and there were a large number of new bone at the edge of defect, and a small amount of new bone could be seen at the edge of defect in blank group and other parts of defect had been covered by the dense fibrous connective tisssue, and the amount of osteotylus in control groupB lied in between it in control group1 and it in blank group; Biomechanics revealed that maximum load of osteotylus in experimental group were significantly highter than in control groupA&B, and lower than normal skull group (P<0.05); Maximum strain displacement of osteotylus in control groupA&B were significantly highter than in experimental group (P<0.05),and the result of maximum strain displacement of osteotylus had no statistically significant difference between control groupA and control groupB(P>0.05),and it also had no statistically significant difference between experimental group and normal skull group (P>0.05); the ratio of maximum load and strain displacement in experimental group and normal skull group were significantly highter than in control groupA&B, while it in experimental group was significantly lower than in normal skull group, and it in control groupA was significantly higher than in control groupB(P<0.05).Conclusion:Fibrin sealant as carrier of staphy1ococcus aureus injection for repairing bone is feasible , the complex of fibrin sealant and staphylococcus aureus injection can promote the formation of new bone.更多还原