富血小板血浆／人工骨修复兔桡骨骨缺损的实验研究

目的探讨富血小板血浆和羟基磷灰石生物陶瓷复合物修复兔桡骨节段性骨缺损的疗效。方法新西兰大白兔12只,切除兔双前肢桡骨中下段1 cm连同骨膜的骨质造成骨缺损,选择左侧前肢为实验侧,右侧前肢为对照侧。实验侧缺损区植入富血小板血浆加羟基磷灰石生物陶瓷,对照侧缺损区单纯植入羟基磷灰石生物陶瓷。术后第2、4、8和12周分别处死3只实验动物,进行大体观察、X线片、组织学、新生骨面积图像分析和透射电镜等观察两侧桡骨愈合情况。结果术后所有动物无感染、死亡,植入物无脱落。大体标本和X线片显示：术后2周实验侧和对照侧在人工骨与宿主骨交界处均有较多肉芽组织,实验侧略多。第4、8周实验侧人工骨表面及孔隙被新生骨组织包裹填充,人工骨与自体骨吻合好;对照侧骨痂主要限于人工骨两端,与对侧比较相对较幼稚。第12周,实验侧骨缺损修复完全,人工骨表面被皮质骨完全包裹;对照侧在人工骨两端区域有板层骨形成,表面未见连续性骨痂。组织学和透射电镜观察显示：随着术后时间的延长,实验侧骨细胞生长明显优于对照侧,有统计学差异。结论富血小板血浆加人工骨复合对管状骨缺损的修复有明显的加速愈合功能。

Research of the Platele-rich Plasma/Artificial Bone on the Recovery of Rabbit Radial Bone Defect

Objective To investigate the therapeutic effects of platele-rich plasma（RPR）/hydroxyapatite ceramic bioceramic compound on the recovery of rabbit radial bone defect.Methods 12 New Zealand rabbits were artificially made to be bone defect by resecting the 1 cm substantia ossea with periosteum of both radii.The left anterior limbs were implanted RPR and hydroxyapatite ceramic bioceramic,while the right anterior limbs were only implanted hydroxyapatite ceramic bioceramic.Every 3 rabbits were sacrificed on week 2,4,8,and 12,and the both radii healing status was observed by X ray,histology,new bone area image analysis and the transmission electron microscope.Results No rabbit was infected or died,no implantation objects dropped.The X-ray result demonstrated that there was a lot of granulation tissue filled in the juncture of artificial bone and autogenous bone both in the left and right anterior limbs 2 weeks after the operation,but there was much more in the left than in the right side.In week 4 and 8,the artificial bone in the left side were filled and surrounded by newly formed bone,and the anastomose status was good;in the right side,the bony callus mainly located in the both ends of the artificial bone and was more naive than the left side.In week 12,the left bone defect was completely recovered,while no successive bony callus was observed in the right bone defect area.The histology examination and the transmission electron microscope showed that the growth of bone cell in the research side was significantly better than the control side.Conclusion PRP combined with artificial bone could accelerate the healing of long tubular bone defect.