带蒂筋膜瓣与可吸收生物膜构建组织工程骨修复兔骨缺损的放射学比较

目的评估带蒂筋膜瓣包裹法及单纯生物膜包裹构建的组织工程骨对骨缺损修复的效果。方法 24只5月龄新西兰大白兔雌雄不限,制备双侧尺骨中段连同骨膜1cm骨缺损模型,自体红骨髓（ARBM）接种于含BMP的骨诱导活性材料（OAM）制备组织工程骨。将制成的非细胞型组织工程复合物植入骨缺损区,右侧设为A组,采用单纯可吸收生物膜包裹,左侧设为B组,采用带血运深筋膜瓣包裹。各组在4、8、12、16周后进行大体观察、X线检查、光密度比测量并于12周行三点弯曲生物力学测定将数据作统计学处理,用以比较骨缺损修复效果。结果 X线片、大体形态观察显示,外骨痂生长情况、骨干结构的重塑、骨髓腔的再通、植入物的吸收降解、骨性愈合后的力学强度,筋膜瓣组均明显优于生物膜组。光密度比值测量显示,术后8、12、16周2组比较及同组内各时间点间比较差异均有统计学意义（P〈0.05）。结论以带血运筋膜瓣做为膜材料在体内构建的组织工程化骨较单纯应用生物膜包裹构建的组织工程化骨在骨修复过程中具有明显优势。

The radiological comparison between the pedicle fascial flap and the absorbable biomembrane in the process of constructing tissue engineering bone to repair the bone defect in rabbits

Objective To evaluate the bone reparative effect of the tissue engineering bone wrapped by pedicle skin flap with vessels and that wrapped by the simple biomembrane by radiography.Methods 24 New-Zealand 5-month-old rabbits（male or female） were used to prepare the hibateral periosteum-included bone defect models in the middle piece of the ulna,and the length of the defect was 1cm.Autologous red bone marrow was implanted in the tissue engineering bone which was prepared by osteoinductive absorbing material including BMP.The prepared tissue engineering bone was implanted in the bone defect area.The right defects wrapped by the simple absorbable biomembrane were allocated in group A,however,the left defects wrapped by pedicle skin flap with blood supply were allocated in group B.At the fourth,eighth,twelfth and sixteenth week after the operation each group was examined by gross morphology inspection,the radiography（x-ray）,the light density measurement in the repairing area and the three-point curvate biomechanics measurement at the twelfth week after the operation.The data were analyzed by statistics to compare the effect of the bone defect repair.Results Through the observation by radiography and the gross morphological inspection we could see that the state of external callus growth,the structure of the diaphysis,recanalization of the cavum ossis and the absorption,the degradation of the implant and the mechanics intension in group B were superior to those in group A.By the comparison of the light density measurement,the differences between the two groups and the differences at the different time points at the same group at the eighth,twelfth and sixteenth week after the operation were statistically significant（P0.05）.Conclusion The tissue engineering bone using pedicle fascial flap with blood supply as membrane materials is superior to the simple biomembrane wrapped tissue engineering bone during bone repair process.