脉冲电磁场促进兔锁骨骨折愈合的实验研究
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摘要
目的
随着电磁场生物效应研究的不断深入,脉冲电磁场促进骨折愈合的影响一直备受关注。本文通过建立兔锁骨骨折模型,以CT影像学测定、生物力学测定和骨密度测定的结果来观察脉冲电磁场对骨折愈合的影响。最后,探讨脉冲电磁场对促进骨折愈合的机理,以期为脉冲电磁场临床治疗的广泛应用提供理论依据。
材料和方法
1.动物的处理
1.1动物的选择和分组以成年日本大耳白兔12只为对象,根据实验需要我们建立模型对照组,伤科接骨片组和脉冲磁场治疗组三组,将成兔随机编入三个组之中,每组各四只。
1.2造模与治疗建立一个简单、实用和较为完善的兔锁骨骨折模型。在无菌操作条件下,以右侧锁骨中段为中心,取长约2cm切口,沿锁骨干的方向依次切开暴露,以剪刀造成0.5cm的斜形骨折,以丝线固定锁骨断段,冲洗后逐层缝合切口,以无菌敷料覆盖伤口。术前一小时和术后三天给予庆大霉素4万肌注以预防伤口感染。动物随机分组,脉冲磁场组动物进行脉冲治疗仪治疗,将治疗仪两磁极分别置于兔右侧锁骨部伤口处及背侧,每日治疗2次,每次半小时；伤科接骨片组,给兔喂用伤科接骨片,每日3次,每次0.4g；模型对照组,将两同等大小铝板分别置于兔右侧锁骨部伤口处及背侧每日治疗2次,每次半小时,不做其他处理。治疗四周后所有家兔以空气栓塞处死,采集锁骨标本进行各项指标检测。
2观察指标
2.1 CT检测：截取原骨折线两端长度约5mm骨段,CT摄片并测取骨痂厚度,重复测量3次,取平均数值。
2.2生物力学检测：将标本置于力学测试机的夹具上固定进行扭转力矩。当机器扭转加载速度以外旋10°／min的速率加载致标本骨折,从载荷角度位移曲线上由计算机软件自动计算每厘米长度的扭转力矩。将其并与健侧进行对比,以减少动物锁骨长度及粗细的差异对实验造成的影响。
2.3骨密度测定：将骨痂标本在丙酮中脱水脱脂3次,每次12小时,然后烘干,在骨密度测定仪中测出标本的骨密度。
3统计学分析实验结束后采用SPSS16.0软件对实验数据进行处理,各配对资料间比较采用t检验,多组计量资料的多重比较采用q检验。
结果
CT片检测结果显示：脉冲磁场治疗组的骨痂生成明显高于伤科接骨片组和模型对照(P<0.01)；伤科接骨片治疗组也优于模型对照组。(P<0.01)
生物力学检测结果显示：脉冲电磁场治疗组家兔锁骨的扭转力矩明显高于其他两组(P<0.05)；伤科接骨片治疗组与模型对照组效果相当。(P>0.05)
骨密度测定结果显示：与健侧比较,脉冲电磁场治疗组骨量丢失的最少(P<0.01)。伤科接骨片治疗组较对脉冲磁场治疗组骨钙含量下降3.78%；模型对照组较对脉冲磁场治疗组骨钙含量下降5.31%。(P<0.01)伤科接骨片与对照组比较也能有效的提高骨钙含量。(P<0.05)
结论
脉冲电磁场对于骨折愈合有明显的促进作用,较之临床药物伤科接骨片效果更佳。
Objective
Pulsed Electromagnetic fields has always been of concern on promoting fracture healing as the deepening of magnetic field on study of the biological effects. The animal model is established to observe the effects of Pulsed Electromagnetic Fields on promot-ing fracture healing by results of CT detection, biomechanical test and bone density measurement. Finally, discusses the mechanism of Pulsed Electromagnetic Fields to promote fracture healing, for providing theory basis about the widely clinical treatment.
Methods
Materials and methods
1 Animal treatment
1.1 Animal selection and grouping 12 adult white rabbits of Japan are targeted. According to the experiment requires the establishment of model control group, Shangkejiegu bip group and Pulsed Electromagnetic Field treatment group. Rabbits are divided into three groups randomly.
1.2 Modeling and treatment To establish a more feasible and more perfect rabbits'bilateral clavicle fracture model. In the sterile operating condition, adult rabbits are taken about 2cm incision in the center of middle clavicle and exposed the clavicle followed by incision, scissors caused bilateral clavicle fracture. Then subclavian stump are fixed by silk after washing powder and sprinkling of penicillin to prevent infections, sutured incision layer by layer and covered the wound with sterile dressing. Each of rabbits continue to be injected GM 3 days after intramuscular. Pulsed Electromagnetic Fields group is treated by therapeutic apparatus. Two poles on the right clavicle Department of rabbits were placed in the wound and the dorsal, daily regular treatment is half an hour. Shangkejiegu chip group is fed rabbits per day 1.2g. Model control group not do other treatment unless pulse two the same size of poles on the right clavicle and the dorsal half an hour a day. All rabbits are killed after four weeks and taken samples of various indicators of bilateral clavicle to test.
2. Outcome Measures
2.1 CT detection:The original fracture line at both ends of a length are intercept to 5mm of bone segment, then photo to film (tube distance of 120cm, voltage 40kV, exposure time 0.02 seconds). Take the bone cortex thickness measurement in the film thickness. Repeat measurements to three times and take average.
2.2 Biomechanical test:The callus specimens are placed on a mechanical testing machine fixture fixed to the torsional stiffness and failure torque test. When the machine other than the loading speed reverse rotation ten min rate of load-induced fracture of specimens, from the load point displacement curve by the computer software automatically calculates the length of the torsional stiffness per centimeter, the damage is caused by fractures of torque. Compare with the healthy side, the experimental impact is reduced by animal collarbone length and thickness differences. 2.3 Bone Density Measurement:The callus specimens are dehydrated in acetone defatted three times of each time 24 hours, then drying, constantting weight, taking dry weight, calculating their size and finding the bone density according to Archimedes law of buoyancy.
After the experiment, SPSS16.0 is used to deal with the experimental data. Paired data are compared by the t test and multiple sets of measurement data are compared by the q test.
Results
CT results show that:Pulsed Electromagnetic Fields therapy treatment side is significantly higher than the control side (P <0.01). Bilateral have the same effect in Shangkejiegu bip treatment group (P>0.01), while the treatment groups are significantly higher than the control group. (P<0.01)
The biomechanical testing results show that:Pulsed Electromagnetic Fields group is significantly higher than the torsional rigidity of clavicle in the other two groups (P<0.05). Shangkejiegu bip treatment group has control effect with the control group. (P>0.05),
The bone mineral density results show that:Compare with Pulsed Electromagnetic Fields, the Shangkejiegu bip treatment group decrease by 3.78%on the density.while the control group decrease by 5.31%on the density. (P<0.01)
Conclusion
Pulsed Electromagnetic Fields for fracture healing and local osteoporosis have obvious therapeutic effect, compare with the clinical traumatology bone chip commonly used oral medication better effect.
随着电磁场生物效应研究的不断深入,脉冲电磁场促进骨折愈合的影响一直备受关注。本文通过建立兔锁骨骨折模型,以CT影像学测定、生物力学测定和骨密度测定的结果来观察脉冲电磁场对骨折愈合的影响。最后,探讨脉冲电磁场对促进骨折愈合的机理,以期为脉冲电磁场临床治疗的广泛应用提供理论依据。
材料和方法
1.动物的处理
1.1动物的选择和分组以成年日本大耳白兔12只为对象,根据实验需要我们建立模型对照组,伤科接骨片组和脉冲磁场治疗组三组,将成兔随机编入三个组之中,每组各四只。
1.2造模与治疗建立一个简单、实用和较为完善的兔锁骨骨折模型。在无菌操作条件下,以右侧锁骨中段为中心,取长约2cm切口,沿锁骨干的方向依次切开暴露,以剪刀造成0.5cm的斜形骨折,以丝线固定锁骨断段,冲洗后逐层缝合切口,以无菌敷料覆盖伤口。术前一小时和术后三天给予庆大霉素4万肌注以预防伤口感染。动物随机分组,脉冲磁场组动物进行脉冲治疗仪治疗,将治疗仪两磁极分别置于兔右侧锁骨部伤口处及背侧,每日治疗2次,每次半小时；伤科接骨片组,给兔喂用伤科接骨片,每日3次,每次0.4g；模型对照组,将两同等大小铝板分别置于兔右侧锁骨部伤口处及背侧每日治疗2次,每次半小时,不做其他处理。治疗四周后所有家兔以空气栓塞处死,采集锁骨标本进行各项指标检测。
2观察指标
2.1 CT检测：截取原骨折线两端长度约5mm骨段,CT摄片并测取骨痂厚度,重复测量3次,取平均数值。
2.2生物力学检测：将标本置于力学测试机的夹具上固定进行扭转力矩。当机器扭转加载速度以外旋10°／min的速率加载致标本骨折,从载荷角度位移曲线上由计算机软件自动计算每厘米长度的扭转力矩。将其并与健侧进行对比,以减少动物锁骨长度及粗细的差异对实验造成的影响。
2.3骨密度测定：将骨痂标本在丙酮中脱水脱脂3次,每次12小时,然后烘干,在骨密度测定仪中测出标本的骨密度。
3统计学分析实验结束后采用SPSS16.0软件对实验数据进行处理,各配对资料间比较采用t检验,多组计量资料的多重比较采用q检验。
结果
CT片检测结果显示：脉冲磁场治疗组的骨痂生成明显高于伤科接骨片组和模型对照(P<0.01)；伤科接骨片治疗组也优于模型对照组。(P<0.01)
生物力学检测结果显示：脉冲电磁场治疗组家兔锁骨的扭转力矩明显高于其他两组(P<0.05)；伤科接骨片治疗组与模型对照组效果相当。(P>0.05)
骨密度测定结果显示：与健侧比较,脉冲电磁场治疗组骨量丢失的最少(P<0.01)。伤科接骨片治疗组较对脉冲磁场治疗组骨钙含量下降3.78%；模型对照组较对脉冲磁场治疗组骨钙含量下降5.31%。(P<0.01)伤科接骨片与对照组比较也能有效的提高骨钙含量。(P<0.05)
结论
脉冲电磁场对于骨折愈合有明显的促进作用,较之临床药物伤科接骨片效果更佳。
Objective
Pulsed Electromagnetic fields has always been of concern on promoting fracture healing as the deepening of magnetic field on study of the biological effects. The animal model is established to observe the effects of Pulsed Electromagnetic Fields on promot-ing fracture healing by results of CT detection, biomechanical test and bone density measurement. Finally, discusses the mechanism of Pulsed Electromagnetic Fields to promote fracture healing, for providing theory basis about the widely clinical treatment.
Methods
Materials and methods
1 Animal treatment
1.1 Animal selection and grouping 12 adult white rabbits of Japan are targeted. According to the experiment requires the establishment of model control group, Shangkejiegu bip group and Pulsed Electromagnetic Field treatment group. Rabbits are divided into three groups randomly.
1.2 Modeling and treatment To establish a more feasible and more perfect rabbits'bilateral clavicle fracture model. In the sterile operating condition, adult rabbits are taken about 2cm incision in the center of middle clavicle and exposed the clavicle followed by incision, scissors caused bilateral clavicle fracture. Then subclavian stump are fixed by silk after washing powder and sprinkling of penicillin to prevent infections, sutured incision layer by layer and covered the wound with sterile dressing. Each of rabbits continue to be injected GM 3 days after intramuscular. Pulsed Electromagnetic Fields group is treated by therapeutic apparatus. Two poles on the right clavicle Department of rabbits were placed in the wound and the dorsal, daily regular treatment is half an hour. Shangkejiegu chip group is fed rabbits per day 1.2g. Model control group not do other treatment unless pulse two the same size of poles on the right clavicle and the dorsal half an hour a day. All rabbits are killed after four weeks and taken samples of various indicators of bilateral clavicle to test.
2. Outcome Measures
2.1 CT detection:The original fracture line at both ends of a length are intercept to 5mm of bone segment, then photo to film (tube distance of 120cm, voltage 40kV, exposure time 0.02 seconds). Take the bone cortex thickness measurement in the film thickness. Repeat measurements to three times and take average.
2.2 Biomechanical test:The callus specimens are placed on a mechanical testing machine fixture fixed to the torsional stiffness and failure torque test. When the machine other than the loading speed reverse rotation ten min rate of load-induced fracture of specimens, from the load point displacement curve by the computer software automatically calculates the length of the torsional stiffness per centimeter, the damage is caused by fractures of torque. Compare with the healthy side, the experimental impact is reduced by animal collarbone length and thickness differences. 2.3 Bone Density Measurement:The callus specimens are dehydrated in acetone defatted three times of each time 24 hours, then drying, constantting weight, taking dry weight, calculating their size and finding the bone density according to Archimedes law of buoyancy.
After the experiment, SPSS16.0 is used to deal with the experimental data. Paired data are compared by the t test and multiple sets of measurement data are compared by the q test.
Results
CT results show that:Pulsed Electromagnetic Fields therapy treatment side is significantly higher than the control side (P <0.01). Bilateral have the same effect in Shangkejiegu bip treatment group (P>0.01), while the treatment groups are significantly higher than the control group. (P<0.01)
The biomechanical testing results show that:Pulsed Electromagnetic Fields group is significantly higher than the torsional rigidity of clavicle in the other two groups (P<0.05). Shangkejiegu bip treatment group has control effect with the control group. (P>0.05),
The bone mineral density results show that:Compare with Pulsed Electromagnetic Fields, the Shangkejiegu bip treatment group decrease by 3.78%on the density.while the control group decrease by 5.31%on the density. (P<0.01)
Conclusion
Pulsed Electromagnetic Fields for fracture healing and local osteoporosis have obvious therapeutic effect, compare with the clinical traumatology bone chip commonly used oral medication better effect.
引文
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