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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 the effects of indometacin topical application, systemic application at different time points, local combined systemic application and local debridement on the heterotopic ossification of hip joint in rabbits. Methods Divided two trials, a period of 18 rabbits, the establishment of hip heterotopic ossification model. Fifty-two rabbits in the second phase were randomly divided into 9 groups, and the above interventions were respectively performed. X-ray films were taken at 4, 6, 8 and 12 weeks respectively to observe the occurrence of heterotopic ossification. Results The incidence of heterotopic ossification in the animal model used in this study was 40.6%, 62.5% and 71.9% at 4, 8 and 12 weeks respectively. The incidence of heterotopic ossification in local debridement was significantly lower than that in control (33.3% vs 70%, P <0.05). The incidence of heterotopic ossification in topical indometacin group (60%) was not significantly different from that in control group (70%). The incidence of heterotopic ossification (30%) in indometacin group was significantly lower than that in control group (70%) after 3d (P <0.05). The incidence of heterotopic ossification in indomethacin group (62.5%) was not significantly different from that in control group (70%) after 7 days. Conclusions Intraoperative radical debridement can reduce the occurrence of heterotopic ossification. Intravenous indometacin does not contribute to the prevention of heterotopic ossification. Indomethacin is administered orally in the early postoperative period (within 3d) Can reduce the incidence of heterotopic ossification.