体外冲击波联合高压氧治疗骨不连的实验研究

目的：探讨体外冲击波（ESW）联合高压氧（HBO）治疗兔桡骨骨折骨不连的效果及作用原理。方法选用标准健康实验雄性新西兰大白兔50只，无菌条件下制作兔双侧桡骨骨不连模型，最后造模成功48只，利用随机数字表将实验动物随机分成4组，每组12只。其中 A 组为体外冲击波联合高压氧治疗组；B 组为单纯高压氧治疗组；C 组为单纯体外冲击波治疗组；D 组为对照组，分别在治疗前及治疗后第4、8、12周摄 X 线片并处死部分实验动物取活组织进行大体观察、骨痂钙水平测定、光镜检查骨痂成骨细胞计数，最后进行统计学分析。结果 X 线片观察，A 组与 B 、C 、D 组骨不连间隙4、8、12周差异有统计学意义（P＜0．05），骨痂生成量4、8、12周差异有统计学意义（P＜0．05）。 A 、C 两组骨钙水平4、8、12周差异均有统计学意义（P＜0．05），骨痂成骨细胞计数4、8周差异有统计学意义（P＜0．05）。结论体外冲击波联合高压氧对骨不连的治疗效果优于单纯体外冲击波治疗，单纯高压氧治疗对骨不连无明显帮助，高压氧可作为体外冲击波治疗骨不连的一种良好的协同方法。

Treatment on bone nonunion by extracorporeal shock wave combine hyperbaric oxygen

Objective To explore the effect and action principle of extracorpoporeal shock wave(ESW) combine hyperbaric oxygen(HBO) in bone nonunion treatment .Methods Totally 50 standard New Zealand white rabbits were chosen ,and 48 rabbits were successfully made to models .Then ,they were divided into four groups by using the random number table ,12 in each group . The group A was in ESW combine HBO group ;The group B was in hyperbaric oxygen group ;The group C was in pure ESW group ;The group D was in control group .X‐ray inspected before treatment and after treatment in 4 、8 、12 weeks .The calcium con‐tent was checked ,the osteoblast in bone callus was observed by the optical microscope ,and the data was analyzed by statistics .Re‐sults There was a significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the nonunion gap(P< 0 .05) ,there was significant difference in 4 ,8 ,12 weeks between group A and group B ,C ,D in the generation bone callus(P< 0 .05) .Callus calci‐um content of group A was higher than group C ,the difference was statistical significance(P< 0 .05) ,there was significant differ‐ence in 4 ,8 weeks between group A and group C in callus osteoblast count(P < 0 .05) .Conclusion ESW combine HBO treatment for bone nonunion is better than pure ESW therapy ,simple hyperbaric therapy has no obvious help for the treatment of bone nonun‐ion ,HBO can be used as a good synergy method in the extracorporeal shock wave treatment of bone nonunion .