应用抗感染重组合异种骨对开放性骨折术后骨缺损的修复作用  

Anti-infective reconstituted bone xenograft for the repair of bone defect foll owing open fracture surgery

作　　者：姜海[1] 刘建[1] 胡蕴玉[1] 袁志[1] 孟国林[1] 

机构地区：[1]解放军第四军医大学西京医院全军骨科研究所,陕西省西安市710032

出　　处：《中国临床康复》2005年第18期4-5,共2页Chinese Journal of Clinical Rehabilitation

基　　金：全军"九五"指令性课题基金资助(96L052)~~

摘　　要：目的:探讨抗感染重组合异种骨对开放性骨折术后骨不连和骨缺损的修复作用。方法:选择2000-10/2003-04第四军医大学西京医院骨科开放性骨折术后四肢长骨骨缺损患者13例,7例术后无菌性骨缺损,6例术后出现感染性骨缺损。对无菌性骨缺损行断端清理,感染性骨缺损行彻底清创,均用外固定,抗感染重组合异种骨植入治疗。有软组织缺损的行植皮或皮瓣转移术。观察术后开始负重时间,每月拍X射线片观察骨缺损修复及再感染发生情况。结果:按意向处理分析,13例患者均进入结果分析。随访时间1年7个月。①术后带架平均开始负重时间3.6个月。②骨折塑形后拆架时间4个月～1年6个月,平均10.4个月。③骨愈合时间8例单纯横断或斜型骨折2～7个月,5例粉碎骨折4～10个月。④13例均未再出现感染。结论:抗感染重组合异种骨能促进骨愈合,修复骨缺损,并有抗感染作用,患者对最终结局满意,可作为开放性骨折术后骨缺损修复的一种较好选择。AIM:To investigate the outcome of nonunion and bone defect following open fra cture surgery repaired with anti- infective reconstituted bone xenograft. METHODS:Thirteen patients with long bone defects of low limbs after open frac ture surgery including 7 postoperative aseptic bone defect and 6 postoperative i nfective bone defect were selected from Department of Orthopaedics,Xijing Hospit al,Fourth Military Medical University between October 2000 and April 2003.Debrid ement was performed on the transected ends of aseptic bone defect and completely on the infective bone defect,both using external fixation,and then implanted wi th anti- infective reconstituted bone xenograft in all the 13 cases.The skin or flap transplantation was performed for the patients with soft tissue defect.The time of weight loading after operation was observed,and X- ray examination was monthly conducted to observe the repair of bone defect and re- infection. RESULTS:According to the intention- to- treat analysis,all the 13 patients were included into the result analysis and followed up for 1.7 years.① The aver age time of weight loading was 3.6 months after operation.② The extraction time of external fixation ranged from 4 months to 1 year and 6 months,mean of 10.4 months.③ The time for bone healing of simple transection or oblique fracture in 8 cases was 2 to 7 months,and for comminuted fracture in 5 cases was 4 to 10 mo nths.④ There was no infection in all the cases. CONCLUSION:Anti- infective reconstituted bone xenograft can accelerate bone healing,repair bone defect and prevent infection.It is an optimal choice to trea t bone defect following open fracture defect attributing to patients' satisfacti on to the final outcomes.

关 键 词：生物相容性材料 骨折 开放性 骨移植 

分 类 号：R683[医药卫生—骨科学]