Maurer P, Meyer L, Eckert A W, Berginski M, Schubert J
Klinik und Poliklinik für Mund-Kiefer- und Plastische Gesichtschirurgie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097 Halle, Germany.
Int J Oral Maxillofac Surg. 2006 Mar;35(3):231-6. doi: 10.1016/j.ijom.2005.07.016. Epub 2005 Sep 23.
In this study, the oxygen partial pressure in the cancellous bone substance of the mandible was measured for the first time with a polarographic fine needle probe. This has so far only been established in soft tissue. The aim was to prove and to test the feasibility in principle of this method of measurement in order to ascertain the normal values for the O2 partial pressure in healthy bone. These values were afterwards compared with the results of measurements in areas of different pathological bone conditions in order to assess the clinical suitability of the method for "mapping" during mandibular resection. Measurements of oxygen partial pressure were made in a total of 42 patients (16 women, 26 men). Of these, 12 patients with clinically normal bones served as a control group. Seventeen patients had osteoradionecrosis following radiation treatment, and 13 patients presented with chronic osteomyelitis of the mandible. All measurements were carried out with a polarographic fine needle probe applied to the cancellous bone substance. The statistical analysis included a comparison of the mean values of the oxygen partial pressures measured. No statistical correlation between oxygen partial pressure and pH and hemoglobin values could be detected. The average oxygen partial pressure in the healthy mandibular bone was 71.4 mmHg. In non-healthy bone, the value fell to an average of 30.6 mmHg (osteoradionecrosis 32.3 mmHg, chronic osteomyelitis of the mandibular bone 28.4 mmHg). Statistically, the differences in the group values ascertained were highly significant (P < 0.005). The data found show that this method can be successfully used to detect poorly perfused bone. The values are reproducible and reflect the clinical situation. In the long term, the method appears to be a suitable diagnostic tool for assessing the oxygen supply in bone in studying various clinical problems related to bone surgery.
在本研究中,首次使用极谱细针探头测量了下颌骨松质骨内的氧分压。迄今为止,这一测量仅在软组织中得以实现。目的是证明并测试这种测量方法在原理上的可行性,以确定健康骨骼中氧分压的正常值。随后将这些值与不同病理性骨状况区域的测量结果进行比较,以评估该方法在下颌骨切除术中“绘图”的临床适用性。对总共42例患者(16名女性,26名男性)进行了氧分压测量。其中,12例临床骨骼正常的患者作为对照组。17例患者在放疗后发生放射性骨坏死,13例患者表现为下颌骨慢性骨髓炎。所有测量均使用应用于松质骨的极谱细针探头进行。统计分析包括对所测氧分压平均值的比较。未检测到氧分压与pH值和血红蛋白值之间存在统计学相关性。健康下颌骨中的平均氧分压为71.4 mmHg。在不健康骨骼中,该值降至平均30.6 mmHg(放射性骨坏死为32.3 mmHg,下颌骨慢性骨髓炎为28.4 mmHg)。从统计学角度来看,所确定的组值差异具有高度显著性(P < 0.005)。所发现的数据表明,该方法可成功用于检测灌注不良的骨骼。这些值具有可重复性并反映了临床情况。从长远来看,该方法似乎是评估骨骼氧供应以研究与骨外科相关的各种临床问题的合适诊断工具。