摘要
目的观察吲哚美辛的局部应用、不同时间点开始全身应用、局部结合全身应用以及局部清创冲洗等措施对于家兔髋关节异位骨化形成的干预效果。方法分二期实验,一期18只家兔,建立髋关节异位骨化模型。二期58只家兔,随机分为9组,分别实施上述各种干预措施,4、6、8、12周时分别摄X线片,观察异位骨化发生情况。结果本研究采用的动物模型的异位骨化发生率在4、8、12周时分别为40.6%、62.5%、71.9%。局部清创冲洗组异位骨化发生率(33.3%)比对照组(70%)明显下降(P<0.05)。局部应用吲哚美辛组异位骨化发生率(60%)与对照组(70%)无明显差异。术后3d开始口服吲哚美辛组异位骨化发生率(30%)比对照组(70%)明显下降(P<0.05)。术后7d开始口服吲哚美辛组异位骨化发生率(62.5%)与对照组(70%)无明显差异。结论术中彻底的清创冲洗能降低术后异位骨化的发生;伤口内局部应用吲哚美辛无助于异位骨化的预防;术后早期(3d以内)开始口服吲哚美辛可降低术后异位骨化的发生。
Objective To observe different effects of application of indometha cin in different ways on heterotopic bone formation around the hip in rabbits. M ethod This experiment was conducted in 2 phases. In the first phase, 18 rabbits were used to establish an animal model of heterotopic ossification around the hi p. In the second phase, 58 rabbits were divided into 9 groups randomly. They wer e treated respectively with local administration of indomethacin, oral administr ation of indomethacin at different time points, both local and oral administrati on of indomethacin, and local debridement and flushing. X-ray photographs were taken for all the rabbits at the 4th, 6th, 8th and 12th weeks after operation to observe the formation of heterotopic bone. Results The rates of heterotopic bon e formation for this animal model were respectively 40.6%, 62.5%and 71.9%at t he 4th, 8th and 12th weeks after operation. Compared with the control group, the group which was treated with debridement and flushing experienced a significant decrease in the rate of heterotopic bone formation (from 33.3%to 70%, P< 0.05 ). This rate for the group treated with local administration of indomethacin in the wound was 60%, which showed no significant difference from that for the con trol group. This rate for the group treated with oral indomethacin beginning 3 d ays postoperatively (30%) decreased significantly compared with the control gro up (70%, P< 0.05). This rate for the group treated with oral indomethacin admin istration beginning 7 days postoperatively was 62.5%, which had no significant difference from that for the control group. Conclusions Debridement and flushing during the operation is an effective method to reduce the formation of heteroto pic bone. Local administration of indomethacin in the wound is not effective eno ugh to reduce the formation of heterotopic bone. Oral administration of indometh acin within 3 days postoperatively can significantly reduce the formation of het erotopic bone.
出处
《中华创伤骨科杂志》
CAS
CSCD
2005年第5期447-451,共5页
Chinese Journal of Orthopaedic Trauma
