硅胶膜管联合BMP／HA修复大块骨缺损实验研究

目的：探讨硅胶膜（SGM）管与骨形态发生蛋白（BMP）和羟基磷灰石（HA）复合的修复兔长骨缺损的效果。方法：制备兔桡骨中段1．2cm缺损模型，实验组缺损区外围包绕硅胶膜，其内分别填充自体骨，BMP／HA，HA三种材料：对照组仅填充HA；空白组骨缺损区未填充，通过X线摄片，光学显微镜，立体计量学分析和生物力学评价对骨缺损区愈合效果进行.分析。结果：术后1个月，SGM＋BMP／HA组骨缺损区见有大量的类骨质，明显优于其他组，第2个月，SGM＋自体骨组与SGM＋BMP／HA组植入区有大片新骨形成，术后3个月，SGM＋自体骨级瑟SGM＋BMP／HA组骨缺损基本修复并出现骨组织改建现象，此时，SGM＋HA组与对照组骨缺损区也有少量新骨形成，空白缺损区为纤维组织充填，结论：硅胶膜管与自体骨或BMP／HA联合用于修复骨缺损成骨效果更佳，因为硅胶膜的屏障作用可使骨缺损区受到引导成骨和放导成骨的双重作用。

The experiment study on repair of massive bone defect with use of silica gel membrane combined with BMP/HA

Objective: To study the efficacy of Silica Gel Membrane (SGM) with Bone Morphogenetic Protein (BMP) and Hydroxyapatite (HA) in repairing segmental bony defect.Methods: The 1.2 cm bone defects were designed at radii in rabbits, and the defects wrapped by SGM as a tube were filled with Autograft (A), BMP/HA, HA as the experimental group, HA only as the Control group, and the free group.The defects were observed by X ray, History,Stereometry and Biomechanics at 1,2,3 months postoperative separately.Results: At the 1st month, a greaat amount of osteoid and new capillary can be found in the defects filled by SGM BMP/HA.After the 2nd month, much new bone was found in both the SGM A group and the SGM BMP/HA group.At the 3rd month, The new bone islands were conjuncted together and reconstructed in both the SGM A group and the SGM BMP/HA group, while little new bone formed in the SGM HA group and the HA group.All the defects in the free group were filled by fibrous tissue.Conclusions: The effects of SGM A and SGM BMP/HA on repairing the segmental bony defect are best, because SGM has an important role in protecting defect area from connective tissue invading.The defect area can be repaired by either guiding or inductive bone regeneration throughout the healing.