医用磷酸钙和硫酸钙骨替代物在骨缺损修复中的疗效对比分析  

Efficacy of medical calcium phosphate and calcium sulfate in bone defect repair： a comparative analysis

作　　者：陈志强[1] 于洪建[2] 韩立仁[1] 韩士章[1] 

机构地区：[1]聊城市人民医院骨科,252000 [2]滨州市人民医院创伤骨科

出　　处：《中华创伤杂志》2012年第10期917-920,共4页Chinese Journal of Trauma

摘　　要：目的探讨人工合成的医用磷酸钙和硫酸钙在骨缺损中行骨替代的临床疗效。方法将2000年2月-2011年10月收治的骨创伤合并骨缺损患者85例，按骨替代物选择不同分为磷酸钙组（43例）与硫酸钙组（42例）。均进行骨科常规处理，行外固定（外固定架、石膏）或内固定（钢板、钢针）。磷酸钙组43例均使用医用磷酸钙，硫酸钙组42例均使用医用硫酸钙。比较两组患者术后并发症、骨折愈合时间及骨替代物吸收时间。结果本组85例骨创伤合并骨缺损的患者进行人工骨填充后，骨折均临床愈合，磷酸钙组平均愈合时间为12．5周（9～17周），硫酸钙组平均愈合时间为11．3周（7～15周）。硫酸钙组均未发生任何并发症或异常反应。磷酸钙组出现切口渗出4例，经换药后愈合。平均随访时间54．5周（14～70周），磷酸钙组平均吸收时间较硫酸钙组多7．3周（P〈0．05）。结论医用磷酸钙和硫酸钙人工骨都能用作骨替代物，在内外固定辅助下具有方便、安全、愈合优良等特点。硫酸钙比磷酸钙更坚固，支撑作用较强。硫酸钙作为骨替代比磷酸钙临床疗效更确切，并发症少且术后愈合时间短。Objective To investigate the clinical effects of synthetic medical calcium phosphate and calcium sulfate as the bone replacements for bone defects. Methods A total of 85 bone trauma pa- tients combined with bone defects treated between February 2000 and October 2011 were randomized to calcium phosphate group （ n = 43 ） and calcium sulfate group （ n = 42 ） according to bone substitutes. The patients had orthopedic conventional treatment and then received external fixation （ external fixators, plas- ters） or internal fixation （plates, needles）. Forty-three patients in the calcium phosphate group were all treated with medical calcium phosphate and 42 patients in the calcium sulfate group were all treated with medical calcium sulfate. Postoperative complications, fracture healing time and bone substitute absorption time of the two groups were observed and compared. Results After artificial bone filling for bone de- fects, all fractures were healed, with average healing time of 12.5 weeks （range, 9-17 weeks） in the cal- cium phosphate group and 11.3 weeks （range, 7-15 weeks） in the calcium sulfate group. No complica- tions or abnormal reactions occurred in the calcium sulfate group, whereas four patients with incision exu- dation was founded in the calcium phosphate group, and was cured after dressing change. The average follow-up period was 54.5 weeks （range, 14-70 weeks）. Average absorption time of bone substitute for the calcium phosphate group was 7.3 weeks, longer than that for the calcium sulfate group （ P 〈 0.05 ）. Conclusions Medical calcium phosphate and calcium sulfate artificial bones can both be used as bone substitutes and are characterized by convenience, safety and good healing under the auxiliary of internal and external fixators. The calcium sulfate is sturdier and has relatively stronger supporting ability than the calcium phosphate. As the bone substitute, the calcium sulfate has more precise clinical effects, fewer complications and shorter healing time than the ca

关 键 词：生物相容性材料 硫酸钙 磷酸钙 骨缺损 

分 类 号：R687.3[医药卫生—骨科学]