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球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折的实验研究
王方
2012-05-25
导师邹德威
专业外科学
授予单位北京大学
授予地点北京大学解放军306医院教学医院
学位硕士
关键词动物模型 球囊 胫骨平台骨折 硫酸钙 骨质疏松
其他题名Study on balloon distension and fixtion by injectable calcium sulfate treatment of osteoporotic and depressed tibial plateau fracture
分类号R687.3
摘要

                第一部分:大型犬骨质疏松动物模型的建立

 

目的:采用激素注射联合低钙饮食的方法快速建立大型犬骨质疏松动物模型。

 

方法:健康雌性杂种犬16只,体重27±1.8 kg5-7岁龄,随机分2组(每组8只):实验组喂低钙饲料,静脉注射地塞米松磷酸钠注射液2.5mg/kg,每周2次;对照组喂食正常犬饲料,静脉注射生理盐水2.5ml/kg,每周2次。实验前、实验4周、8周进行骨密度测定、生化检查,实验12周进行骨密度测定、生化检查、骨生物力学及骨组织形态学检查。

 

结果:与对照组相比,实验组应用激素合并低钙饮食8周骨密度显著性降低(P0.05),12周进一步降低(P0.01);实验中两组血钙无显著性差别(P0.05),实验组4周血磷较对照组降低(P0.05),8周及12周血磷进一步降低(P0.01),实验4812周实验组碱性磷酸酶均显著性升高(P0.01);实验组第12周骨小梁面积百分数(%Tb.Ar)、骨小梁厚度(Tb.Th)、骨小梁数量(Tb.N)较对照组显著降低(P0.01),骨小梁分离度(Tb.Sp)较对照组显著增高(P0.01);实验第12周实验组腰椎压缩极限载荷、极限强度和压缩模量均明显低于对照组(P0.01,股骨三点弯曲极限载荷实验组低于对照组(P0.05)。

 

结论:激素注射联合低钙饮食的方法短期内成功建立了大型犬骨质疏松动物模型,该模型具有人类骨质疏松症的临床特性,为进行外科学实验研究提供了依据。

         

 第二部分:球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折的实验研究

 

目的:评估球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折(SchatzkerⅢ型)的疗效。

 

方法:健康雌性犬16只,造成骨质疏松,分为2组:A12只,B4只。A组犬处死取材,随机选择16个胫骨构建胫骨外侧平台塌陷性骨折模型,其中8个实施球囊扩张复位注射型硫酸钙固定术(A1组),另外8个实施撬拨复位植骨螺丝钉内固定术(A2组),对两组骨折复位情况进行测量,未行手术的8个胫骨为对照组(A3组),术后对A1A2A3三组胫骨外侧平台感兴趣区(interest region, IR)进行生物力学测试。B组犬活体行与A1组相同的手术,术后4周取材做组织学检查。

 

结果:A1组骨折复位程度和生物力学测试结果不比A2组差,组织学检查:B组硫酸钙逐渐被吸收,硫酸钙周围有新生骨小梁。

 

结论:球囊扩张注射型硫酸钙固定治疗骨质疏松性犬胫骨平台塌陷性骨折复位效果优良、生物力学性能优越,有良好的成骨效果。

 

英文摘要

Part 1Study on establishment of an animal model of osteoporosis in large canine    

 :

Objective: To quickly establish an animal model of osteoporosis in large canine using the method of hormone injections with low calcium diet

 

Methods: Health large female hybrid canine 16, weight only 27±1.8 kg, 5-7 years old age were divided into 2 groups (each group only 8) : Experimental group were fed low calcium feed, and intravenous injected dexamethasone sodium phosphate injection 2.5 mg /kg, twice per week; Control group were injected physiological saline, twice per week, and fed canine normal feed. When before the experiment, on 4 weeks and on 8 weeks to determine the bone mineral density and biochemical indicator, when 12 weeks to determine the bone mineral density, biochemical indicator, biomechanics of bone and examine bone tissue morphology.

 

Results: Compared with the control group, bone mineral density of the experimental group (hormone injections with low calcium diet) on 8 weeks significantly reduced (P0.05), and on 12 weeks further reduced (P0.01); During the experimental process the calcium of the two group had no significant difference (P0.05), on 4 weeks the phosphorus of the experiment group reduced (P0.05) than the control group, on 8 and 12 weeks further reduced (P0.01), on 4, 8 and 12 weeks the alkaline phosphatase of the experiment group significantly rised(P0.01); On 12 weeks the Tb.Ar, Tb.Th and Tb.N of the experiment group was significantly lowered while the Tb.Sp of the experiment group was significantly rised (P0.01 for both) compared with the control group; On 12 weeks The compressive ultimate load, ultimate strength and compression modulus of lumbar of the experiment group was significantly lower than the control group(P0.01), the 3 point bending ultimate load of the experiment group was lower than the control group(P0.05).

 

Conclusion: The method of hormone injections with low calcium diet method in the short term successfully established large osteoporosis animal model, and this model has human osteoporosis clinical characteristics, providing the basis for experimental research of surgery.

  

Part 2Study on balloon distension and fixtion by injectable calcium sulfate treatment of osteoporotic and depressed tibial plateau fracture

 

ObjectiveTo evaluate the curative effect of implementing balloon distension and fixtion by injectable calcium sulfate to treat osteoporotic and depressed tibial plateau fracture (Schatzker type) on animal model. 

 

MethodsHealth large female canine 16 were established osteoporosis animal model. Then they were randomly divided into 2 groups: A group 12, B group 4. A group of canine was killed to draw materials, randomly selected 16 tibial to build tibial plateau fracture model, in which randomly select 8 to implement balloon distension and fixtion by injectable calcium sulfate (A1 group), the other 8 implement reduction by leveragebone grafting and internal fixation by screw(A2 group), then measured the degree of reduction of the two groups, take the 8 tibia left that were not do surgery as control group (A3 group). The interest region(IR) of the lateral tibial plateau of A1, A2, and A3 groups were analyzed for biomechanical testing. B group canine were performed the same operation as A1 group in vivo, and after 4 weeks were taken out on a histological examination.

 

ResultsA1 group is as good as A2 group in the degree of reduction and biomechanical testing. Histological examination of B group: calcium sulfate is absorbed gradually, there are new bone trabeculas around calcium sulfate.

 

ConclusionThe treatment of canine tibial plateau fracture using balloon distension and fixtion by injectable calcium sulfate lead to good reduction, superior biomechanics performance, and satisfactory osteogenesis.

 

语种中文
出处http://xuewei.bjmu.edu.cn/simpsearch.action?keyword=球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折的实验研究&dbid=72
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文献类型学位论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/105437
专题北京大学解放军306医院教学医院
作者单位北京大学解放军306医院教学医院
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王方. 球囊扩张注射型硫酸钙固定治疗骨质疏松性胫骨平台塌陷性骨折的实验研究[D]. 北京大学解放军306医院教学医院. 北京大学,2012.
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