自体颅骨粉末移植和膜引导再生技术修复兔颅骨缺损的组织学研究

Histological Observation of Autogenous Bone Dust Grafting and Membrane Guided Regeneration Technology to Repair Skull Defects

目的应用自体颅骨粉末移植和膜引导再生技术修复兔颅骨缺损模型,观察其组织学演变过程。方法选取50只新西兰大白兔,建立直径1 cm的颅骨全层缺损模型。移植自体骨粉修复兔颅骨缺损,并在移植的骨粉上放置可吸收生物膜,以纤维蛋白胶固定。术后2、4、6、8、12周取材进行组织学观察。结果术后2周,可观察到颅骨缺损区大量骨粉,炎性细胞、毛细血管和成纤维细胞由周围向内浸润,骨粉被吞噬吸收,周边小部分是新生骨,两者之间界限明显。术后4周,观察到骨粉吸收和新骨形成活跃区域向缺损中央内移较多,新生编织骨有所增粗,编织骨之间连接更为紧密,观察到的组织和细胞成分与术后2周时无明显变化。术后6周,基本观察不到未被吸收的骨粉,新生的编织骨变粗,联系更紧密。术后8周,完全观察不到骨粉,缺损中央部已形成单层新生骨,周边部形成的编织骨较为粗大,与正常骨紧密连接,形成初级骨髓腔。术后12周,缺损中央部形成双层新生骨,可见新生骨的改建和较为成熟的骨髓腔,腔内容物形态和成分与正常骨无区别。结论应用自体颅骨粉末移植和膜引导再生技术可以修复颅骨缺损,其组织学演变过程实质是引导性和诱导性骨再生的过程。

Objective To repair the skull defects by using autogenous skull bone dust grafting and membrane guided regeneration technology, and to investigate its histological evolution. Methods Fifty New Zealand white rabbits were selected. A whole thick defect with the diameter of 1 cm was created in the parietal bone of every rabbit. The defect was grafted with autogenous skull bone dust and two pieces of absorbable membrane on two side. After 2, 4, 6, 8, 12 weeks, the defects were harvested for histological observation. Results Two weeks after operation, a large number of bone meal was observed in the defect area. Inward infiltration of inflammatory cells, capillaries and fibroblasts were observed. Bone meal was swallowed in the central area, new bone was formed in the surrounding area and a clear boundary was observed between the two area. Four weeks after operation, the boundary had moved a lot to the central area. New woven bone was thickened, the connection between the woven bone became more closely. Tissue and cell components had no obvious change compared with 2 weeks after operation. Six weeks after operation, bone meal was almost absorbed, the woven bone became thicker and the connection was more closely. Eight weeks after operation, no bone dust could be observed, a monolayer new bone was formed in the central area. The woven bone in the surrounding area was relatively thick and closely connected with normal bone. The primary bone marrow cavity was formed. Twelve weeks after operation, double new bone was observed in the central area. New bone remodeling and mature bone marrow cavity were also observed. The morphology and composition of bone marrow cavity had no difference compared with normal bone. Conclusion Histological evolution of autogenous bone dust grafting and membrane guided regeneration technology to repair skull defects is guided and induced bone regeneration.