髓芯减压BMP植入治疗股骨头坏死的血流量及病理改变

The Effect of Core Decompression on Femoral Head Blood Flow in Necrosis of the Femoral Head and the Pathologic Change of Core Decompression、Bone Graft、BMP on Necrosis of the Femoral Head

目的 :研究股骨头坏死的早期治疗方法。方法 :选取 6月龄健康新西兰白兔 42只 ,随机分组 ,注射激素制作股骨头坏死模型 ,行髓芯减压加植骨、髓芯减压植骨加BMP治疗 ,SPECT观察血流量的改变。结果 :随着激素应用时间的延长 ,股骨头局部核素吸收量逐渐减少。应用激素 4周血流量降至正常的 72 % ,6周为 69% ,8周为 5 6%。髓芯减压术后 2周恢复至正常的 82 % ,4周时恢复正常。髓芯减压加BMP骨泥治疗组 4周后镜下改变为大量新生骨形成 ,爬行替代坏死的骨小梁 ,且在新生骨周围有大量的新生血管形成。结论 :髓芯减压术能改善坏死股骨头的血运 ,骨诱导蛋白 (BMP)对坏死的股骨头具有骨诱导作用 ,能刺激新生骨的形成 ,爬行替代坏死的骨小梁 。

Objective: To seek a kind of effective therapeutic mean to early stage necrosis of the femoral head.Methods:forty three New Zealand adult rabbits weighting an average of 3.0kg were divided into groups randomly.Make animal model by injecting methylprenisolone.Three groups animals underwent core decompression and bone grafting/core decompression and bone grafting and BMP respectively,use SPECT to observe femoral head blood flow.Results:Radioactivity absorption of femoral head decreased gradually in the process of sterid injection.Four weeks after injection of steriod blood flow of femoral head decreased to 72% of normal,six weeks after injeation decreased to 69% of normal,eight weeks after injeation decreased to 56% of normal,the blood flow of femoral head increased to 82% of normal two weeks after core decompression.And the blood flow of femoral head increased to normal four weeks after core decompression.There were a lot of new growth bone formation to creeping replace necrotic bone trabeculae 4 weeks after core decompression and bone grafting and BMP.Conclusion:Core decompression can improve blood circulation of femoral head.Bone morphogenic protein can stimulate new bone growth to creeping replace necrotic bone trabeculae.