组织工程骨修复9例颅骨缺损畸形初步报道  

The clinical application of tissue engineered bone combined with autologous human bone marrow mesenchymal stem cells and partially demineralized bone matrix to repair cranial defects

作　　者：李新庆[1] 王有刚[1] 李春和[1] 崔磊[2] 刘广鹏[2] 李宇琳[2] 

机构地区：[1]南京医科大学附属常州市第二人民医院整形外科,江苏常州213003 [2]上海组织工程研究与开发中心,上海200235

出　　处：《中国口腔颌面外科杂志》2010年第5期396-400,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：常州市卫生局重大科研课题(ZD200610);常州市科技局社会发展项目(CS2006201)~~

摘　　要：目的:探讨利用自体骨髓间充质干细胞(BMSC)作为种子细胞的组织工程骨修复外伤后颅骨缺损畸形的可行性。方法:运用自体BMSC组织工程骨技术,对9例外伤术后颅骨缺损患者行颅骨修复手术。抽取患者自体骨髓,密度梯度离心法分离BMSC,经体外扩增和成骨诱导后,接种部分脱钙骨支架材料,构建组织工程骨。细胞材料复合物体外共培养1周后,手术植入颅骨缺损区。分别于术后1周和3、6、12个月进行临床外形和三维CT检查,随访治疗效果。结果:术后1周三维CT显示,颅骨缺损区被所植入的组织工程骨填充,头颅外形明显改善。术后3至12个月CT显示,组织工程骨形成并修复颅骨缺损,新生骨与骨缺损断端融合。9例患者中2例术后失访,2例高龄患者及大面积骨缺损患者发生不同程度的组织工程骨吸收现象,其余均良好地修复了颅骨缺损。结论:通过选择适宜的病例,以自体BMSC作为种子细胞,运用组织工程技术可以在人体内形成稳定的组织工程化骨并修复颅骨缺损。PURPOSE：To study the application of human bone marrow mesenchymal stem cells （BMSC） as seed cells for tissue-engineered bone to repair the cranial bone defects caused by trauma. METHODS： Nine operations using tissue-engineered bone constructed by autologous BMSC were performed from Jun. 2006 to Jan. 2010. Briefly, BMSC were isolated, proliferated and osteogenically induced in vitro, then were loaded on partially demineralized bone matrix （pDBM）. After co-cultured for 1 week, the cell/scaffold complexes were used for implantation. Gross observation and 3D-CT were performed before and after implantation （1 week and 3, 6, 12 months）, respectively. RESULTS：In the nine cases, 3D-CT at one week post-implantation showed that the defect was filled with engineered bone, and the gross appearance of skull was obviously improved. After 3 and 12months, new bone formed and fused with host bone, and the defects were repaired. It was found that no bone formed in one old patient and in one large defect. CONCLUSIONS： In selected cases, BMSC can be used as seed cells for tissue-engineered bone to repair cranial bone defects.

关 键 词：颅骨缺损 组织工程骨 骨髓基质干细胞 脱钙骨 

分 类 号：R651.1[医药卫生—外科学]