人工骨与异体骨用于良性骨肿瘤刮除后重建的比较研究  

A comparative study of artificial bone and allograft for the reconstruction of bone defects after benign bone tumor resection

作　　者：杨勇昆[1] 牛晓辉[1] 张清[1] 郝林[1] 丁易[1] 徐海荣[1] 

机构地区：[1]北京积水潭医院骨肿瘤科,100035

出　　处：《中国骨与关节杂志》2012年第6期565-568,573,共5页Chinese Journal of Bone and Joint

基　　金：首都医学发展科研基金资助项目(2009-3096)

摘　　要：目的比较人工骨(羟基磷灰石+β-磷酸三钙)与同种异体松质骨在良性骨肿瘤刮除后骨缺损重建中的临床应用效果。方法研究自2009年1月至2009年12月在我院接受人工骨与同种异体松质骨植骨的两组病例。两组病例在治疗时间、年龄、性别、病种、病灶部位、植骨量和随访时间等方面均匹配良好。通过随访影像学和临床情况,比较两组病例植骨术后的愈合速度和愈合率,分析人工骨愈合的影响因素。结果人工骨与同种异体骨的初步愈合率分别为100%和87.5%(P=0.246);人工骨与同种异体骨的平均愈合时间分别为9.1个月(3-12个月)和11.2个月(6-15个月)(P=0.718)。回归分析显示患者性别(P=0.592)、年龄(P=0.754)、病灶部位(P=0.671)、病种(P=0.250)和植骨量(P=0.798)均不是影响人工骨愈合的显著因素。人工骨组与同种异体骨组患者术后MSTS评分分别为平均28.5分(21～30分)和平均28.7分(26～30分)(P=0.869)。人工骨植入术后未见伤口感染、不愈合、排异反应等并发症。结论羟基磷灰石+β-磷酸三钙材质人工骨用于肢体良性骨肿瘤刮除后骨缺损的重建,愈合效果良好,术后未见不良反应,可使患者临床获益。Objective To compare the clinical effects of artificial bone （calcium phosphate hydroxyapatite ＋ β-tricalcium phosphate） and cancellous bone allograft for the reconstruction of bone defects after benign bone tumor resection. Methods The patients who received artificial bone and cancellous bone allograft respectively in our hospital from January 2009 to December 2009 were divided into 2 groups. The 2 groups matched well in the treatment time, age, gender, disease category, site of lesion, bone graft volume, follow-up time and so on. Based on the imaging and clinical results during the follow-up, the healing speed and healing rate after bone graft between the 2 groups were compared, and the influencing factors in artificial bone healing were analyzed. Results The initial healing rates of artificial bone and allograft were 100% and 87.5% respectively （P=0.246）; the mean healing time of artificial bone and allograft was 9.1 months （range; 3-12 months） and 11.2 months （range; 6-15 months） respectively （P=0.718）. The regression analysis showed that gender （P=0.592）, age （P=0.754）, site of lesion （P=0.671）, disease category （P=-0.250） and bone graft volume （P=0.798） were not significant factors influencing artificial bone healing. The mean Musculoskeletal Tumor Society （MSTS） scores of the 2 groups after surgery were 28.5 （range; 21-30） and 28.7 （range; 26-30） respectively （P=0.869）. Such complications as wound infection, nonunion, rejection reaction and so on did not occur after artificial bone graft. Conclusions The artificial bone （calcium phosphate hydroxyapatite ＋ β-tricalcium phosphate） for reconstruction of bone defects after limb benign bone tumor resection could achieve satisfactory healing effects, without adverse reactions postoperatively. The patients had good fimctional recovery after surgery.

关 键 词：人工骨 同种异体骨 骨肿瘤 羟基磷灰石 Β-磷酸三钙 

分 类 号：R738.1[医药卫生—肿瘤] R318[医药卫生—临床医学]