羟基磷灰石／胶原人工骨在创伤后骨缺损修复中的初步研究  

The primary study on hydroxyapatite / collagen in bone defects caused by trauma

作　　者：何森[1,2] 张其清[1] 

机构地区：[1]中国医学科学院,中国协和医科大学生物医学工程研究所,天津300192 [2]天津市天和医院骨科,天津300050

出　　处：《生物医学工程与临床》2008年第1期56-60,共5页Biomedical Engineering and Clinical Medicine

基　　金：国家科技攻关计划课题资助（2001BA706B-17-D）;天津市科技发展计划项目（033803011）

摘　　要：目的评估羟基磷灰石，胶原（hydroxyapatite/collagen，HAC）人工骨在创伤后骨缺损修复中的临床效果。方法48例创伤后四肢骨骨折患者，无其他病史，分为2组。试验组25例，其中男性15例，女性10例，年龄22～82岁，平均年龄45.3岁。对照组患者23例，其中男性13例，女性10例，年龄21～81岁，平均年龄46岁。对所有患者进行骨折切开复位，选择合适的内固定。试验组于固定后，在骨缺损处、骨髓腔、骨折线周围直接植骨，羟基磷灰石，胶原人工骨修复材料植入量0.4～4.0g不等。对照组不植入羟基磷灰石，胶原人工骨。结果两组46例病例获随访。试验组中2例失随访，余23例患者无局部或全身不良反应，骨折均达临床愈合。X线片显示,术后1～3个月材料植入区与缺损周围的骨组织间界限模糊，有新骨形成，3～6个月材料植入区内有明显的新骨长入，人工骨与骨组织融合，骨缺损基本修复。对照组3例延迟愈合和1例骨折不愈合患者在功能上恢复较差；试验组与对照组比较具有统计学意义，P〈0．05。结论胶原，羟基磷灰石人工骨具有良好的材料，细胞界面，使材料本身更具备与骨键合的能力。其三维多孔结构便于骨组织的长入，生物降解性有利于骨组织的改建和塑形，具有良好的临床应用前景。Objective To evaluate the clinical efficacy of hydroxyapatite/collagen （HAC） as a bone graft substitute in repairing of bone defects caused by trauma. Methods Forth-eight patients with frature of bones of limbs were enrolled in this study,25 patients in experimental group（male 15,female 10,aged 22 ～ 82 years,mean age 45.3 years）,23 patients in control group（male 13, female 10,aged 21 ～ 81 years,mean age 46 years）. All patients were treated with operation of osteotomy and suitable internal fixation. HAC were implanted in bone defects,morrow cavity and fracture line periphery,amount from 0.4 to 4 grams in experimental group. Patients in control group were treated without HAC. Results The clinical results of 46 patients were obtained, 2 cases losed following up in experimental group. Of 23 patients in experimental group,part or general adverse reaction did not happenned,and obtained fracture healing. The interface between normal bone and grafted defect became vague in advance of new bone formation by 1 ～ 3 months roentgenographically by X-ray photography,and obliteration of the interface was evident at 3 to 6 months;Artificial bone was fused with bone tissue and defect locus was recovered. The recovery of function were not good in control group,3 cases with delay healing and 1 case with bone fracture no-healing. Conclusion HAC has good biocompatibility and biodegradability. It was a safe, effective bone graft substitute material for the filling of defects caused by trauma.

关 键 词：胶原 羟基磷灰石 创伤 骨缺损 

分 类 号：R318[医药卫生—生物医学工程]