羟基磷灰石体内植入的实验研究

目的 探讨颗粒型羟基磷灰石(hydroxyapatile，HA)植入体内后的凝固、塑形和机体对植入物的反应情况。方法 实验用新西兰大白兔16只，随机分成二组：实验组和对照组。取兔鼻小柱正中小切口，对照组鼻背筋膜下行钝性分离出遂道后植入固体硅胶，实验组钝性分离至骨膜下，植入等体积的颗粒状HA。术后肉眼观察局部组织改变、HA塑形情况以及与骨粘连的牢固度。3周后处死动物取植入物周围组织行组织病理学检查。结果 两组动物在术后3周内手术部位无化脓、破溃和植入物外露。实验组术后2天植入物凝结成块状，1周时完全变硬，3周时均达到骨性硬度，术后2周植人物与骨完全粘连，经皮难以推动。对照组植入物硬度无改变，在隧道内可以推动。术后3周时两组植入物周围组织均有不同程度的纤维组织增生，且有很薄的纤维囊壁形成，以对照组更为明显。结论 颗粒型HA植人体内后可快速凝固；且和骨组织牢固融合，机体组织反应轻。

Experimental study on the implantation of hydroxyapatite

Objective To study the coagulation, moulding of the implants and reactions of the hosts to the implants when the hydroxyapatites(HA) are implanted to the rabbit.Methods Sixteen rabbits were randomly divided into two groups, experimental group and control group. Median micro|incisions of columella were made, and solid silica gel was implanted into tunnels which were bluntly dissected under the fascia of nasal dorsum in the control group, and granular HA was implanted in subperiosteum in the experimental group. After the operations, gross changes of the local tissues, moulding of HA and the adhesive rigidity of the implants to the nasal bones were investigated. Three weeks after the operations, all the rabbits were killed and tissues beside the implants were harvested and examined with light microscopy.Results within three weeks of post-operation, there were no suppuration and inflammation of the local tissues and exposure of the implants. In the experimental group, the granular implants coagulated to block two days after the operations, completely changed to hard one week after the operations, and reach to rigidity equivalent to bone three weeks after the operations. Two weeks after the operations, the HA were completely adhesive with the nasal bone and were hard to push freely. In the control group, there were no obvious changes in rigidity of the implants, and the implants can be pushed freely in the tunnels. In the two groups, there existed hyperplasia of fibrous tissue in different degrees in the tissues beside the implants, and thin fibrous capsules around the implants three weeks after the operations. The pathological changes were more obvious in the control group than the experimental group.Conclusion Conclusion The implanted granular HA can coagulate quickly, fused with the host bone firmly and cause slight reaction of the host.