珊瑚人工骨/自体骨髓复合移植修复颌骨缺损临床应用  

Clinical application on composite grafts of coral combined with autologous bone marrow reconstructing jaw defects

作　　者：郑有华[1] 任材年[1] 张志光[1] 曾融生[1] 陈卓辉[1] 

机构地区：[1]中山大学光华口腔医学院口腔颌面外科,广东广州510055

出　　处：《中国现代医学杂志》2005年第8期1227-1230,共4页China Journal of Modern Medicine

基　　金：广东省医学科研基金资助项目(A2002235)

摘　　要：目的探讨珊瑚人工骨复合自体骨髓细胞移植修复颌骨缺损的临床效果。方法选用珊瑚人工骨复合自体骨髓细胞移植修复颌骨缺损,共治疗32例病人,骨病变面积9.0～48.0cm2,平均24.4cm2。术中从髂嵴穿刺抽取5～9mL富含骨髓基质细胞的自体骨髓,将珊瑚骨浸泡在红骨髓中,使其完全渗透,然后将其修复颌骨缺损。术后随访1￣8a。术后拍X线片动态检查;选择6例病例,术后进行99mTc-MDP核素骨三相显像动态观察。结果32例病人中伤口Ⅰ期愈合28例,伤口Ⅱ期愈合2例,2例因感染失败。99mTc-MDP核素骨三相显像,术后1个月,植骨区的中央有核素浓聚,提示已有新骨形成;X线检查术后3个月,珊瑚骨密度开始降低,提示出现吸收;术后9～24个月,复合珊瑚骨完全被宿主骨取代,不留痕迹。结论珊瑚人工骨复合自体骨髓细胞移植修复颌骨缺损临床效果良好,是一种可供选择的骨代用品。[Objective]To research the clinical effects on composite grafts of coral combined with autogous bone marrow being used to reconstruct jaw defects. Composite grafts of coral combined with autogous bone marrow were used to reconstruct 32 cases of jaw defects after neoplasm resection. The size of bone lesion ranged from 9.0 cm2 to 48.0 cm2,average 24.4cm2. Drawing 5～9 mL bone marrow from iliac crest ,put the coral into bone marrow and become composite coral, and then the composite coral was utilized to reconstruct jaw defects. The follow-up period was through 12 months to 8 years, average 4 years and 3 months. Osteogenesis was observed dynamically with radiography and scintigraphy postoperation. Of 32 cases, twenty-eight cases healed in one-stage, two cases healed in second-stage, and two cases failed because of infection. An increased radionuclide uptake began to be shown in the area of grafts at the 1st month. Coral resorption was observed at the 3rd month, and it was completely replaced by host newly bone at 9 to 24 months. [Conclusion] Composite coral graft may accelerate the repair of jaw defects, and it is a kind of excellent bone substitute to be elected.

关 键 词：珊瑚 骨髓细胞 颌骨缺损 组织移植 

分 类 号：R782.23[医药卫生—口腔医学]