摘要
目的探讨创伤性股骨颈骨折愈合过程各时段股骨头的血流变化。方法 18只山羊采用手术方法造成左侧股骨颈移位骨折,以2枚加压螺钉和1枚骨圆针固定骨折。术前及术后4、6、8、12周分5次行放射性核素三相骨显像检查,观察股骨头血流的动态变化,同时辅以X线、组织学方面的检查予以对照,并了解其相互关系。结果①血流相与血池相,术后4周左侧股骨头血流减少,6周时血供开始恢复,1 2周血供明显增多。②静态显相,术后4周头/头比值低于骨折前,8周达最大值,然后开始下降,至术后1 2周时头/头比值接近于术前水平。③组织学观察,术后4周左侧股骨头可见骨细胞变性、坏死,同时小梁间已有组织细胞及成骨细胞增生,提示股骨头开始修复;术后6～8周修复反应达高峰,至12周股骨头内坏死灶基本清除,修复反应也明显减弱。结论骨折后早期(4周),由于血管损伤、血供受阻,股骨头血流减少,骨代谢低下;而后随着血管再生修复和骨重建,股骨头血流逐渐恢复正常。
Objective To explore changes of the femoral head blood flow in each period after femoral neck fracture.Methods A total of 18 goats were operated into experimental models of femoral neck displaced fractures.The goats were examined by three-phase bone imaging before the left femoral neck fracture and 4,6,8,12 weeks after the fracture to evaluate femoral head blood flow.Results ①Blood flow and pool curve showed left femoral head blood flow reduced 4 weeks after operation,and began to increase 6 weeks after operation.②Four week after operation,the isotope uptake ratio of right and left femoral head was lower than that before fracture.The isotope uptake ratio has reached its maximun 8 weeks after operation.Then it would decreased and reached the preoperative level 12 weeks after fracture.③The result of observation in histology was coincident with three-phase bone imaging.Conclusion Femoral head blood flow reduced early period after fracture because of vascular injury and it.would increase with reconstructing of the femoral head blood supply and the restoration of bone.
出处
《河北医科大学学报》
CAS
2009年第8期780-782,后插1,共4页
Journal of Hebei Medical University
关键词
股骨颈骨折
骨折愈合
血液循环
山羊
femoral neck fracture
fracture healing
blood circulation
goats
