自体髂骨血管化治疗胫骨骨折后骨不连26例  

The treatment for the nonunion of tibia with the vascularization of autoilium graft

作　　者：赵斌[1] 吴大鹏[1] 周迎鋒 李康[1] 李小伟[1] 

机构地区：[1]河南省卫辉市新乡医学院一附院骨科,河南新乡453100

出　　处：《中国民康医学》2010年第7期795-797,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:用自体髂骨移植并血管化治疗胫骨骨折不愈合,并通过MR I、X线检查,观察移植骨血管化和骨折愈合情况,并探讨其在治疗骨折不愈合中的疗效及可行性。方法:将2006年1月至2008年11月于我院临床诊断26例胫骨骨折不愈合患者,随机分为A、B两组,A组采用常规胫前入路,于胫骨内侧皮下找到隐动脉分支,将所取血管束不切断置于骨折两断端中央,取合适长度自体髂骨块,中央纵行剖开,将所取骨块置于骨折端之间,包绕移植的血管束,用钛合金钢板将髂骨与隐动脉分支牢固于骨缺损处。B组常规取髂骨植骨钛合金钢板内固定,用对比剂首过灌注成像技术分别于术后4、8、12周作磁共振灌注成像检查及X线检查,了解移植骨块再血管化情况和骨折愈合情况。结果:试验组各项监测指标(基线、最大斜率指标、最大信号强度上升值)较对照组有差异,P<0.05,有统计学意义。结论:将移植骨与移植血管束恰当的有效结合,即将移植骨不挤压移植血管束,移植血管供应移植骨所需营养,达到将移植骨血管化,较单纯移植骨更可靠、更有效解决骨折不愈合,缩短骨折愈合时间。Objective：To treat the nonunion of tibia with the viscularization of atuoilium graft and observe the union by the method of MRI and X - ay, by which to study the feasibility of the viscularization of atuoilium graft. Methods ： Collecting the patients hospitalized by our hospital between January 2006 to November 2007 and grouping them to group A and B and treat them with the com- bination of saphenous artery and autoilium graft in group A and plate with autoilium graft in group B, respectively, observing the result with the inspection of MRI and X - ray after 4, 8, 12 weeks of operation and detecting the development and union and the vaseulariza- tion of autoilium. Results： There were great difference of the indexes in group A and B, including baseline, slope and revaluation of the signal, P 〈 0. 05 , indicating there was statistic meaning and group A exceed group B. Conclusions ： Combing the autoilium graft and viscularization is hopeful and effective to the treatment of nonunion of tibia comparing with the pure autoilium graft.

关 键 词：髂骨血管化 胫骨 骨不连 磁共振灌注成像 

分 类 号：R683.42[医药卫生—骨科学]