可吸收生物膜对自体颅骨粉末修复颅骨缺损影响的大体标本和影像学观察

General and radiological observation of degradable biomembrane effect on the repair of cranial defects with autogenous skull bone dust

目的建立兔自体颅骨粉末移植修复颅骨缺损的动物模型,进行可吸收生物膜和不可吸收生物膜影响对比的研究,以更好地指导自体颅骨粉末移植修复颅骨缺损的临床工作。方法新西兰大白兔30只,每只大白兔的顶部人工形成2个直径为1cm的颅骨全层缺损,孔A、B。孔A作为实验组,移植人工形成缺损时收集的骨粉,并在移植的骨粉上面放置可吸收生物膜。孔B为对照组,在移植的骨粉上面放置不可吸收生物膜;术后2、6、12周各处死10只动物,并取材进行大体观察和影像学(CT和X线)分析。结果术后2周,孔A、B都迅速地以松质骨完全修复整个缺损。术后6周,移植的骨粉被逐步吸收,形成的松质骨生长、改建,形成新骨,部分骨性修复缺损;孔A与孔B形成的新生骨面积差异无统计学意义(P>0.05)。术后12周,孔A、B均以较成熟的新生骨和部分纤维性骨痂完全修复整个缺损。孔A与孔B形成的新生骨面积差异无统计学意义(P>0.05)。结论可吸收生物膜和不可吸收生物膜对自体颅骨粉末修复颅骨缺损的影响无明显差异,可替代使用。

Objective To investigate the different effect between degradable and non-degradable biomembrane on the repair of cranial defects with autogenous skull bone dust by establishing animal model for directing clinical work well.Methods Thirty New Zealand white rabbits were selected with sex unlimited.Two whole thick defects（A and B）were created in the parietal bone of every New Zealand white rabbit.Defect A was grafted with autogenous skull bone dust with a piece of PDLLA membrane placed on,and defect B with a piece of pyroxylin membrane placed on as control.After two、six、12 weeks,10 rabbits were killed and the defects were prepared for general observation,X-ray inspection,and 3-dimension CT rebuilding.ResultsDefect A and B were repaired rapidly with new spongy bone two weeks after operation.The autogenous skull bone dust grafted was absorbed gradually six weeks after operation.Some new skull bone in defects A and B was formed by developing and regenerating from spongy bone.Some defects A and B were repaired completely with new skull bone.The quantitative difference of new skull bone in defect A and B was not statistically significant（P0.05）.Defects A and B were repaired completely with more mature crania and fibrous bone 12 weeks after operation.The quantitative difference of new skull bone in defect A and B was not statistically significant（P0.05）.Conclusion The difference of effect between degradable and non-degradable biomembrane on the repair of cranial defects with autogenous skull bone dust is not notable.Non-degradable biomembrane can be replaced entirely by degradable biomembrane.