【摘要】 背景:骨折愈合机制复杂,受到多种因素的影响,骨折延迟愈合、不愈合时有发生,如何促进骨折愈合成为亟待解决的问题。目的:观察周围神经损伤后局部应用神经生长因子对骨折早期愈合的影响。方法:36只健康雄性Wistar大白鼠建立胫骨骨折模型,将其随机分为4组,每组18个肢体。1骨折+盐水组为胫骨骨折予以双侧腓肠肌生理盐水注射。2骨折伴神经损伤+盐水组胫骨骨折伴神经损伤予以生理盐水注射。3骨折+神经生长因子组为胫骨骨折予以局部注射神经生长因子。4骨折伴神经损伤+神经生长因子组为神经损伤、胫骨骨折予以局部注射神经生长因子。对各组骨痂计量学结果等情况进行观察对比。结果与结论:1骨痂量:干预4周时与骨折+盐水组、骨折+神经生长因子组、骨折伴神经损伤+神经生长因子组比较,骨折伴神经损伤+盐水组骨痂量最多,其他3组比较差异无显著性意义(P>0.05)。2骨计量指标:干预2周时,骨折伴神经损伤+盐水组骨吸收表面积明显大于骨折伴神经损伤+神经生长因子组(P<0.05),骨折+盐水组破骨细胞指数明显大于骨折+神经生长因子组(P<0.05);干预4周时,矿化骨小梁宽度,骨折+盐水组明显小于骨折+神经生长因子组(P<0.05),骨折伴神经损伤+盐水组明显小于骨折伴神经损伤+神经生长因子组(P<0.05)。结果提示周围神经损伤后的骨折局部应用神经生长因子均可增强成骨能力,且可有效抑制破骨细胞活动,促进骨折早期愈合。更多还原

【Abstract】 BACKGROUND: Fracture healing mechanism is complex and affected by many factors, and delayed fracture healing or nonunion often occurs. How to promote fracture healing has become a serious problem. OBJECTIVE: To observe the effect of local application of nerve growth factor on early fracture healing after peripheral nerve injury. METHODS: Thirty-six healthy male Wistar rats were selected to establish tibial fracture models, which were randomly divided into four groups, with 18 limbs in each group. Group A: tibial fracture+normal saline injection via bilateral gastrocnemius muscles; group B: tibial fracture+nerve injury+normal saline injection; group C: tibial fracture+local injection of nerve growth factor; group D: tibial fracture+nerve injury+local injection of nerve growth factor. Callus metrology results were compared among different groups. RESULTS AND CONCLUSION: The callus volume was the most in the group B at 4 weeks of intervention, but there were no different among the other three groups(P > 0.05). At 2 weeks of intervention, the bone resorption area was significantly larger in the group B than the group D(P < 0.05), and the osteoclast index was significantly higher in the group A than the group C(P < 0.05); while at 4 weeks of intervention, the mineralized bonetrabecular width was significantly lower in the group A than the group C(P < 0.05) as well as lower in the group C than the group D(P < 0.05). These findings indicate that after peripheral nerve injury, local application of nerve growth factor can enhance the osteogenic ability, effectively inhibit osteoclast activity, and promote the early healing of fracture.更多还原