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1、中国修复重建外科杂志1999年第13卷第5期·321··组织工程·利用可生物降解共聚膜引导骨再生黄岚峰刘建国徐莘香【摘要】目的采用生物降解可吸收材料聚己内酯(PCL)和聚乳酸(PLA)共聚膜修复长骨节段性骨缺损,探讨其引导性骨再生的效果及机制。方法采用兔桡骨中段112cm节段性骨缺损(保留骨膜)动物模型24只,平均分成两组,实验组用膜包绕骨缺损区,对照组缺损区不处置,分别于术后3、6及12周处死动物,进行X线片、大体及组织学观察。结果实验组缺损区骨生长明显优于对照组,术后3周实验组可见明显的骨痂沿膜外生长;术后6周以桥接的外骨痂形成
2、骨性连接;术后12周膜内外均形成骨性连接,对照组从术后6周开始表现为骨不连。结论利用可生物降解的膜性材料可引导骨组织再生,通过膜外骨痂以及形成相对迟缓的膜内骨痂共同完成骨缺损的修复;膜性材料通过屏障作用一方面有效地阻挡纤维组织长入缺损区,防止骨不连形成,另一方面在局部形成营养物质浓聚,并通过表面的微孔为骨细胞生长充当支架,促进骨缺损愈合。【关键词】骨缺损引导性骨再生膜生物降解材料GUIDEDBONEREGENERATIONBYUSINGBIODEGRADABLECO-POLYMERMEM-BRANESINRABBITSöHUANGL
3、an2feng,LIUJian2guo,XUXin2xiang.DepartmentofOrtho2pedicSurgery,TheFirstClinicalHospitalofNormanBethunUniversityofMedicalScience.ChangchunJilin,P.R.China130021.E2mail:ydyy@public.cc.jl.cn【Abstract】ObjectiveTorepairlongbonesegmentaldefectsusingbiodegradablepolyE2caprolac
4、tone(PCL)andpolylacticacid(PLA)co2polymermembranes,andexploreitsroleandmechanisminguidedboneregeneration(GBR).MethodsRabbitradialsegmentaldefects(1.2cminlength,retaintheperiosteum)werecreatedinthisstudy,24animalsweredividedinto2groups.Themembraneswereusedtoenclosethede
5、fectsinexperimentalgroup,andnotreatmentincontrolgroup.After3,6,and12weeksofoperation,X2ray,grossandhistologicalexaminationswereobserved.ResultsTheboneregenerationofexperimentalgroupwasbetterthanthatofcon2trolgroup.Threeweeksafteroperation,obviousexternalcallusalongthem
6、embranewerefoundinexperimentalgroup,andbonylinkingcomposedofexternalcallusbridgewerefoundin6weeksaf2teroperation.After12weeksofoperation,callusbridgeoutsidethemembraneandbonyreunioninsidethemembranewereachivedinexperimentalgroup.Whileincontrolgroup,typicalnonunionwasob
7、servedafter6weeksofoperation.ConclusionGuidedboneregenerationcanbeachievedbyusingbiodegradablemembrane.Thedefectsarerepairedbythemeansofoutsidemembranecallusandrelativelylateinsidemembranecallus.Themembranecanpreventthein2growthoffibroustissueintodefectarea,thusnonunio
8、nareavoid,andkeepahighconcentrationofnutritiveelements,alsoserveasaframeforosteocytegrowthtoenhancebonehealing.【Keywo
