同种异体骨移植重建骨肿瘤切除术后骨缺损  

Allograft implantation in treatment of bone defect after bone tumor resection

作　　者：向阳[1] 刘义[1] 王桂龙 丁茹虎[1] 陈一升[1] 

机构地区：[1]贵阳医学院附属医院骨科,贵阳550004

出　　处：《中国骨肿瘤骨病》2007年第1期32-35,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的评价同种异体骨移植修复骨肿瘤切除后骨缺损的重建方法、疗效、并发症及防治。方法18例骨肿瘤患者年龄15～48岁,平均23岁;其中骨肉瘤10例,软骨肉瘤3例,尤文肉瘤3例,骨巨细胞瘤2例,应用交锁髓内钉、重建钢板、解剖钢板等内固定器材结合同种异体骨关节或骨段移植治疗。随访时间12～50个月,平均36个月。结果14例植骨愈合,3例骨不愈合(其中1例因内固定断裂而行更换),1例异体骨骨折,发生局部免疫反应9例,无肿瘤局部复发。功能结果按Mankin[1]标准评定,优9例,良5例,中4例,优良率77.7%。结论同种异体骨是治疗良恶性骨肿瘤切除术后骨缺损的有效方法,异体骨不愈合、骨折、感染、免疫反应等为常见的并发症,选择合适患者、恰当的内固定、做好术前计划可减少此类并发症的发生。Objective To evaluate the procedure and outcome and complications of allograft implantation in treatment of bone defect after bone tumors resection. Methods Eighteen patients with mean age 23 years were treated with allografts implantation after primary bone tumors resection. There were 10 osteosarcomas and 3 chondrosarcomas and 3 Ewing＇ s sarcomas and 2 giant-cell tumor of bone. The fixations were intramedullary nail and plate or screws. Following-up period ranged from 12 to 50 months （averaged 36 months）. Results Fourteen cases had union and 3 cases non-union （included 1 case with fracture of plate fixation）, 1 allograft fracture and 9 presented immune response. There was no recurrence. Functional results were rated based on the criteria of Mankin and there were 9 excellent and 5 good and 4 fair. The rate of excellent and good was 77.7%. Conclusions Bone allograft implantation is an effective procedure in treatment of bone defect after bone tumor resection. The common complications after large allograft transplantation include infection, nonunion, fracture and immune response. Those complications could be avoid partly if we select the proper patients and appropriate internal fixation and make better preoperative planning.

关 键 词：异体移植物 移植 骨肿瘤 骨缺损 

分 类 号：R738[医药卫生—肿瘤]