不同波长低能量激光对骨折愈合的影响(英文)

Effect of different wave lengths of low power laser on fracture healing

背景:低能量激光对骨折愈合有促进作用,能够加速骨折愈合,缩短骨折愈合时间,增强骨折愈合强度,对早期骨折愈合有较好的疗效。目的:评价不同波长低能量1激光对早期骨折愈合的疗效。设计、时间及地点:随机对照动物实验,于2005-05/2006-05在韩国檀国大学医科大学激光中心完成。材料:60只9月龄的英国Hartley雌性豚鼠,体质量(300±30)g,随机分为632nm,830nm实验组各20只,对照组20只。方法:每只豚鼠左臀部肌肉内注射麻醉药,麻醉成功后,右侧股骨干中段用咬骨钳将其咬断并造成粉碎性骨折,再用1.4mm克斯针经骨髓腔行内固定术。632nm和830nm波长半导体激光仪器分别用于两个实验组。低能量激光照射从术后48h开始,在股骨干骨折区上方垂直照射,每两天1次,照射剂量同为100J/cm2,照射面积同为2.52cm2。最后46只豚鼠成活,其中对照组14只,632nm和830nm实验组各16只。主要观察指标:在第3,6周心脏注射处死豚鼠,提取股骨干标本,采用ModifiedZorluScoringSystem评价骨折愈合情况,包括肉眼观察,影像学CR检查和组织学检查。结果:46只豚鼠均存活,大体观察观察和影像学CR检查结果显示:第3周,632nm和830nm实验组的骨痂形成速率均显著性高于对照组(P<0.01);830nm实验组的骨痂形成量多于632nm实验组(P>0.05)。组织学检查结果显示:第3周,两个实验组造骨细胞的增生聚集显著性大于对照组(P<0.01)。在第3,6周,632nm和830nm两个实验组之间虽然没有显著性差异,但是830nm实验组造骨细胞的增生量高于632nm实验组(P>0.05)。结论:632nm和830nm照射波长治疗对早期骨折愈合均取得较好的效果,830nm波长促进骨折的愈合效果好于632nm波长。

BACKGROUND： Low power laser irradiation has positive effects on fracture healing, including shortening the time of bone union and enhancement of bone formation. OBJECTIVE： To evaluate the effects of different wave lengths in low power laser on early fracture healing. DESIGN, TIME AND SETTING： Randomized, controlled, animal experiment. The study was performed at the Laser Center of Dankook University Medical Center between May 2005 and May 2006. MATERIALS： A total of 60 female English Hartley guinea pigs, 9 weeks old, weighing （300±30） g, were used for this experiment. They were randomly divided into three groups control, 632, and 830 nm groups （n=20）. METHODS： The right femoral middle shaft fractures were made with a bone cutter and fixed with intramedullary nails （1.4 mm diameter K-wire）. The frequencies of 632 nm and 830 nm semi-conductor laser machines were used. The laser irradiations were started 48 hours after operation vertically at the fracture sites and were applied every two days, at 100 J/cm2 of the same irradiation doses and 2.52 cm2 of the same irradiation areas in different irradiation groups. Finally, 46 guinea pigs survived, including 14 in control group, 16 in 632 nm group and 16 in 830 nm group. MAIN OUTCOME MEASURES： Guinea pigs were sacrificed at 3 and 6 weeks separately. The bone healing was assessed by the Modified Zorlu Scodng System, including gross, radiologic and histologic examinations. RESULTS： In the gross and radiologic findings, both 632 nm and 830 nm irradiation groups shown a significantly greater rate of callus formation at postoperatively 3 weeks compared to the control group （P 〈 0.01）. Quantity of callus formation in 830 nm group was more than 632 nm group, but there was no significant difference （P 〉 0.05）. The result of histological findings showed a significant increase of osteoblastic proliferation in two irradiation groups than the control group at 3 weeks postoperatively （P 〈 0.01）. Enhancement of osteoblastic proliferation was more obvious in 830 nm group than in 632 nm group at 3 and 6 weeks, but there was no significant difference （P 〉 0.05）. CONCLUSION： Both 632 nm and 830 nm wave lengths are considered to be optimal irradiation wave lengths for early fracture healing. Moreover, 830 nm irradiation is better than 632 nm irradiation for early fracture healing.