冲击波联合骨髓间充质干细胞治疗骨不连的临床观察  

Clinical study of extracorporeal shock wave therapy combined with autograft of mesenchymal stem cells for bone nonunion.

作　　者：王五洲[1] 邢更彦[1] 张可超 张瑞强 白晓东[1] 

机构地区：[1]武警总医院骨科 [2]武警8660部队医院外科

出　　处：《中国综合临床》2006年第7期636-638,共3页Clinical Medicine of China

基　　金：国家自然科学基金资助项目(30371430);首都医学发展科研基金资助项目(2002-3037)

摘　　要：目的在体外成功分离培养骨髓间充质干细胞(hMSCs)的基础上,观察体外冲击波(ESW)联合自体MSCs移植治疗骨折延迟愈合及骨不连的疗效。方法对17例(观察组)骨不连患者进行体外冲击波联合自体干细胞移植,并与同期只接受体外冲击波治疗的31例(对照组)患者进行疗效观察,每4周复查患肢X线片,9个月后比较愈合率和平均愈合时间。结果2组骨不连患者接受治疗后均观察到新生骨痂的形成,其中对尺桡骨骨折不连接的治疗效果最为明显,胫骨骨不连疗效较差;观察组临床治愈率(88.2%)高于对照组(80.6%);干细胞移植后平均骨折愈合时间较对照组缩短了5.8周,差异有显著性(P<0.01)。结论自体干细胞移植可促进成骨,结合冲击波的微动力学刺激,可以加速骨痂的形成,有利于骨折的愈合,值得临床推广。Objective To study the therapeutic effect of extracorporeal shock wave （ESW） combined with autograft of mesenchymal stem cells （ MSCs ） in the treatment of bone nonunion on the basis of successful marrow aspiration and centrifugation of mesenchymal stem cells. Methods ESW was applied to 17 patients of bone nonunion in combination with autograft of MSCs, and its therapeutic effect was compared with 31 cases treated with single ESW. X-ray was reexamined every four weeks. Nine months later,the union rate and the average time of union were compared. Results Fracture of radius and ulna showed better union than tibia. The healing rate was 88.2% in observation group and 80.6% in control group. Meanwhile, average healing time of autograft cases was decreased by 5. 8 weeks,compared with single ESW therapy （ P 〈 0.01 ）. Conclusion Autograft of MSCs can promote formation of bony callus, which is beneficial to fracture healing, in combination with ESW stimulation.

关 键 词：骨折 骨不连 骨髓间充质干细胞 体外冲击波 

分 类 号：R683[医药卫生—骨科学]