体外冲击波联合高压氧治疗兔桡骨骨折骨不连的实验研究

摘要

目的：探讨体外冲击波联合高压氧治疗兔桡骨骨折骨不连的效果及作用原理。方法选用新西兰雄性健康标准实验大白兔48只（月龄及体重相当），无菌条件下制作兔双侧桡骨骨不连模型，采用随机数字表法随机分成四组，每组12只。其中A组为体外冲击波联合高压氧治疗组；B组为单纯高压氧治疗组；C组为单纯体外冲击波治疗组；D组为对照组，不做任何处理。分别在治疗前及治疗后第2、4、8、12周摄X线片并处死部分实验动物取活组织进行大体观察、骨折间隙变化、骨痂钙含量测定、光镜检查骨痂成骨细胞计数，最后进行统计学分析。结果 X线观察，A组与B、C、D组骨不连间隙4、8、12周差异有统计学意义（ P＜0．05）。 A、C两组骨痂钙元素含量2、4、8、12周差异有统计学意义（ P＜0．05），骨痂成骨细胞计数2、4、8周差异具有统计学意义（ P＜0．05）。结论体外冲击波联合高压氧对骨不连的治疗效果优于单纯体外冲击波治疗，单纯高压氧治疗对骨不连无明显帮助，高压氧可作为体外冲击波治疗骨不连的一种良好的协同方法。%Objective To explore the effect and action mechanism of extracorpoporeal shock wave combined with hyperbaric oxygen in the treatment of bone ununion .Methods Forty-eight health standard experiment New Zeal-and white rabbits were chosen ( months of age are consistent with weights ) , and divided into four groups by using the random number table after the models were made by osteotomy (12 in each group).The group A was extracorporeal shock wave combined with hyperbaric oxygen group; The group B was hyperbaric oxygen group; The group C was pure extracorporeal shock wave group;The group D was in control group , X-ray examination was made before treat-ment and at 2, 4, 8, 12 weeks after treatment;and part of the experimental animals were executed at each time point to get the live tissue for making general observation , observing the change of nonunion gap , detecting the calcium content, using the optical microscope to observe the osteoblast in bone callus , and statistical analysis of the data was made at last.Results X-ray obseversion showed that there was a significant difference in the nonunion gap at 4, 8, 12 weeks between group A and group B , C or D(P<0.05).Callus calcium contents at 2, 4, 8, 12 weeks in group A were higher than those in group C , the difference was statistically significant ( P<0.05 ) .There was a significant difference in callus osteoblast count at 2, 4, 8 weeks between group A and group C (P<0.05).Conclusion Extra-corporeal shock wave combined with hyperbaric oxygen treatment for bone nonunion is better than pure extracorporeal shock wave therapy , simple hyperbaric therapy has no obvious help for the treatment of bone nonunion , hyperbaric oxygen can be used as a good synergy method in the extracorporeal shock wave treatment of bone nonunion .