带蒂筋膜瓣促非细胞型组织工程骨血管化及其对成骨作用影响的动态组织学观察

目的通过对带蒂筋膜瓣在修复骨缺损时促非细胞型组织工程骨血管化及其对成骨作用影响的动态组织学观察,论证带蒂筋膜瓣具有较好的促血管化成骨作用.方法制作动物骨缺损模型及带蒂筋膜瓣,随机分为A、B、C、D四组,对照组:A组单纯植入非细胞型组织工程骨,B组为无蒂筋膜瓣包裹的非细胞型组织工程骨,C组为无蒂筋膜瓣包裹的复合VEGF非细胞型组织工程骨;实验组:D组带蒂筋膜瓣包裹的非细胞型组织工程骨.术后第4、8、12、16周进行骨缺损修复区组织学观察、再生血管图像计量分析、新生骨形态计量分析.结果术后第4、8、12、16周组织学观察,骨修复区新生骨的形成、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解,D组明显优于A、B、C三组.血管图像计量分析及骨形态计量分析显示,除第4周D、C两组比较差异无显著性(P>0.05),其余各时间段D组明显优于A、B、C三组,差异有显著性(P<0.05),且各组前后时间段比较差异亦有显著性(P<0.05).结论带蒂筋膜瓣早期具有明显的促血管化作用,并显著增强中后期的成骨作用,缩短骨修复时间.

Dynamic Histological Observation on the Vascularization Promoted by Pedicle Fascial Flap and Its Effect on Osteogenesis of Uncellular Tissue Engineereing Bone

Objective To demonstrate that pedicle fascial flap has a satisfactory vascularization osteogenesis by dynamic histological observation of effects of pedicle fascial flap on the vascularization of the uncellular tissue engineered bone and the osteogenesis in process of bone defect repairing.Methods Animal model and pedicle fascial flap was made and divided into four groups,Groups A,B,C and D randomly.Control groups were Group A with uncellular tissue engineering bone simply,Group B with uncellular tissue engineering bone packed by the fascial flap without pedicle and Group C with uncellular tissue engineering bone packed by the fascial flap without pedicle combing VEGF.The experimental group was Group D with uncellular tissue engineering bone packed by pedicle fascial flap.The histology observation,vessel image quantitive analysis and the bone morphology quantitive analysis were performed in the repair area of bone defect on the 4th,8th,12th and 16th weeks after operation.Results Group D was superior to Group A,B and C obviously in the formation of new bone in the repair area,the remodeling of diaphysis structure,the recanalization of medullary canal and the absorption and degradation of implant on the 4th,8th,12th and 16th week after operation.The vessel image quantitive analysis and bone morphology quantitive analysis indicated that Group D was superior to Group A,B and C obviously on each period and the difference had statistical Significance except on 4th week between Group D and Group C(P>0.05)and the comparison between the former and the latter in each group also had statistical significance(P<0.05).Conclusion The pedicle fascial flap has obvious vascularization in the early stage and can enhance osteogenesis obviously in midanaphase and shorten the repair period.