游离骨膜骨髓磷酸钙复合移植应用于膜引导性骨再生的实验研究

Experimental study of autologous free periosteum and bone marrow and calcium phosphate cement in membrane guided bone regeneration

目的:将游离骨膜骨髓自固化磷酸钙calciumphosphatecement,CPC应()用于膜引导性骨再生,为临床修复节段性骨缺损探索一条有效的途径。方法:实验兔28只,分成A,B两大组,每组14只,制造两侧兔桡骨中段10mm的骨缺损。A组一侧骨缺损用自体游离骨膜(freeperiosteum,FP)、骨髓bonemarrow,BM和CPC复合移植修复简称FPBMC组,()()另一侧作为空白对照组。B组一侧用自体游离骨膜及吸附骨髓的明胶海绵修复(简称FPBM组),另一侧用硅胶膜(silastic)及吸附骨髓明胶海绵修复(简称SBM组)。于术后第1,2,4,6,8,10,12周分别行双侧桡骨X射线检查及X射线影像评分。于术后第2,4,8,12周切取标本行组织学检查及成骨面积分析。结果:FPBMC组疗效最好,FPBM组及SBM组次之,空白对照组最差。结论:①FPBMC复合移植具有良好的成骨作用,可有效促进骨缺损的修复。②膜下间隙的保持是膜引导性骨再生顺利进行的条件。

AIM:To apply free periosteum bone marrow calcium phosphate cement(CPC) to membrane guided bone regeneration(MGBR) in order to find an effective method to repair segmental bone defects in clinic. METHODS:Twenty eight experimental rabbits were divided into groups A and B, 14 rabbits in each group; bilateral 10 mm segmental bone defects were produced in the radius of rabbits. Group A: one side defect was repaired with free periosteum bone marrow CPC(FPBMC group),and the other side was aimed as control group. Group B: one side defect was repaired with free periosteum bone marrow gelfoam(FPBM group), and the other side defect was repaired with silastic bone marrow gelfoam SBM group.The X ray examinations were done at 1, 2, 4, 6, 8, 10 and 12 weeks after operation and the quantity of the callus formed in bone defects which displayed on radiograph was evaluated. The samples were cut for the histology test and analysis of osteogenic area at 2, 4, 8, and 12 weeks after operation. RESULTS:The curative effect was the best in FPBMC group, better in FPBM group and SBM group, and the worst in the control group. CONCLUSION:① The FPBMC cograft has a significant osteogenic competence.It can efficiently repair bone defects.② The maintenance of crevices inferior to membrane is the requirement for MGBR that can be taken smoothly.