应用3D适形打印制备网状复合体对兔颅骨缺损的修复作用及安全性研究

目的:探讨采用3D适形打印技术制备的羟基磷灰石/聚乳酸网状复合体在兔颅骨缺损中的修复作用及安全性。方法:以24只新西兰兔为研究对象,以羟基磷灰石/聚乳酸为材料,采用3D适形打印技术制备网状复合体,于兔颅骨顶部制成两个颅骨全层缺损,分别为孔A(左)和孔B(右),孔A(阳性对照组)以自体颅骨为修复材料,孔B(实验组)以复合体为修复材料,观察缺损修复区域的形态学、影像学(X线及CT扫描)及组织学检查结果。结果:植入后24周时,形态学显示:阳性对照组可见致密的骨组织修复,与缺损边缘界限不清,实验组中支架孔隙内纤维组织由新生骨质取代,且新生骨成熟度较提高,材料表面有部分吸收。CT扫描观察显示:冠状面上,阳性对照组缺损修复区域与周围正常骨组织融合为一体,实验组修复材料与缺损边缘融合紧密,与周围正常骨组织结合良好,部分边缘结合不连贯。组织学观察显示:实验组材料部分降解,材料间隔可见新生骨小梁。研究中无实验动物死亡,皮肤切口处缝合良好,无皮下积液,无移植物脱出、红肿感染等情况出现。结论:以3D适形打印技术制备的羟基磷灰石/聚乳酸复合体对兔颅骨缺损有较好的修复作用,能促进缺损区域新骨的形成和生长,且安全性较高。

Effects of 3D Conformal Printing on the Repair of Rabbit Skull Defects and Its Safety

ABSTRACT Objective: To study the repair effect and safety of hydroxyapatite/polylactic acid network complex prepared by 3D conformal printing technique in rabbit skull defect. Methods: Twenty-four New Zealand rabbits were used to study, hydroxyapatite/poly- lactic acid were used to prepare of reticular complexes. Two skull defects were made on the top of the rabbit skull, such as hole A (left) and hole B (right), hole A (positive control group)was repaired by the autogenous skull, the hole B(experimental group) was repaired by hydroxyapatite/polylactic. Morphology, radiology (X-ray and CT scan) and histological findings were observed. Results: 24 w, Morpho- logical: positive control group can be seen dense bone tissue, and the boundaries of the defect is unclear. In the experimental group, the fibrous tissue in the scaffold was replaced by the new bone, and the maturity new bone was improved, the material surface is partially ab- sorbed. CT scan showed that the repair area of the coronal plane, the positive control group repair area was integrated with the surround- ing normal bone tissue, the experimental group repair material was closely integrated with the defect edge, and it was well combined with the surrounding normal bone tissue. Histological: part of the material degradation, the material interval can be seen new bone trabeculae. There were no experimental animals died during the study, the suture was good at the incision of the skin, no graft removal, swelling and infection occurred. Conclusion: The hydroxyapatite/polylactic acid complex prepared by 3D conformal printing technique has a good ef- fect on the repair of rabbit skull defects, which can promote the formation and growth of new bone in defect area and has higher safety and further study value.