纤维蛋白凝胶复合骨形态发生蛋白和庆大霉素缓释药物治疗感染性骨缺损的实验研究

目的 探讨将纤维蛋白凝胶(FG)作为骨形态发生蛋白(BMP)及庆大霉素的共同载体,一期治疗感染性骨缺损。方法 48只青紫兰兔,制作慢性骨髓炎模型,清创后造成胫骨干骺端内侧1.5 cm长半环形骨缺损,采用三种方法进行处理:A组,植入FG、BMP和庆大霉素复合物;B组植入FG/BMP复合物;C组作为空白对照。术后观察动物一般情况,作骨细菌培养及其计数,X线摄片及组织学检查。结果 A组感染控制及骨修复均良好,感染控制率、再生骨量明显优于B组;B、C两组在感染控制率上无显著差异;C组动物骨修复差。结论 FG、BMP及庆大霉素复合物具有抗感染及促进成骨的双重作用,可用于感染性骨缺损的治疗,也可用于污染严重的开放性损伤造成的骨缺损的治疗,方法简便、易行。

Experimental Study of Treatment of Infected Bone Defects with Bone Morphogenetic Protein and Gentamicin-loaded Fibrin Glue Drug Delivery System

Objective To probe the treatment of infected bone defects with bone morphogentic protein (BMP) and gentamicin-loaded fibrin glue (FG) drug delivery system, controlling the infection and speeding bony growth and healing at one stage. Methods Experimental treatment of infected bone defects with the composites. Animal models of chronic osteomyelitis were made in 48 rabbits. All foci were debrided thoroughly, and 1.5cm long half-annular bone defects were made in the proximal tibias. Three kinds of implantation were used: A, composites of FG, BMP and gentamicin; B, FG/BMP composites; C, nothing as control. The situation of experimental animals were observed postoperatively, and the healing of infected bone defects was measured radiologically, histologically within 12 weeks following the surgery. Bone bacterial culture and its counts were made in 6 rabbits selected from every group. Results The rates of bone infection controlled of group A was superior to that of group B or C. Obvious bone healing was observed in group A and B, but new bone formation in group A was shown more than that in group B radiologically. Bone repair in group C was not obvious. Conclusion The FG, BMP and gentamicin composites have the effects of anti-infection and speeding bony growth and healing. It can not only be used to treat infected bone defects, but also be used to treat severely polluted bone defects caused by open fracture.