同种异体骨移植治疗易复发性良性骨肿瘤的疗效  

Allogeneic bone grafting for the treatment of recurrent benign bone tumors

作　　者：杨勇志[1] 刘凡 宋亚 谷贵山 YANG Yong-zhi;LIU Fan;SONG Ya;GU Gui-shan(Department of Orthopaedics,the first Bethune Hospital of Jilin University,Changchun,Jilin,130000,China)

机构地区：[1]吉林大学白求恩第一医院骨关节外科,长春130000

出　　处：《中国骨与关节杂志》2018年第12期929-932,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨同种异体骨治疗四肢易复发性骨肿瘤的疗效,包括肢体功能恢复、并发症的发生及同种异体骨最终的转归情况。方法收集2010年4月至2016年8月治疗四肢良性骨肿瘤患者51例,男24例,女27例,年龄6～57岁,平均31.6岁。其中单纯骨囊肿10例,骨纤维结构不良13例,动脉瘤样骨囊肿6例,骨巨细胞瘤8例,内生软骨瘤7例,非骨化性纤维瘤5例,海绵状血管瘤1例及骨膜韧带状血管瘤1例。采用肿瘤刮除植骨术式,视情况辅以加压锁定钢板。其中松质骨植入48例,大段腓骨植入3例。结果随访完整资料51例,随访时间11～87个月,平均43.4个月。异体骨愈合49例,不愈合2例。主要并发症:肿物复发2例;免疫排斥反应3例(后治愈);骨折3例。结论同种异体骨促进成骨、修复骨缺损效果显著,排斥反应发生率低,最终转归情况良好。在彻底刮除骨肿瘤的前提下,并综合使用物理和化学方法处理肿瘤边界后,填充同种异体骨修复易复发良性骨肿瘤造成的骨缺损可取得满意效果。Objective To investigate the curative effects of allogeneic bone on the treatment of recurrent limb bone tumors, including the recovery of limb functions, occurrence of complications and final outcomes. Methods From April 2010 to August 2016, 51 patients with limb benign bone tumors were collected, including 24 males and 27 females. The average age was 31.6 years (range: 6-57 years). There were 10 cases of bone cysts, 13 cases of poor fibrous structure, 6 cases of aneurysmal bone cysts, 8 cases of bone giant cell tumor, 7 cases of endogenous chondroma, 5 cases of non-ossifying fibroma, 1 case of cavernous hemangioma, and 1 case of periosteal ligamentous hemangioma. Complete resection and bone grafting were applied. Plate fixation was supplemented. Cancellous bone implantation was conducted in 48 cases, and large fibula implantation in 3 cases. Results Fifty-one patients were followed up for 11-87 months (mean: 43.4 months). Allogeneic bone healed in 49 cases. Nonunion occurred in 2 cases. Main complications: 2 cases of tumor recurrence, 3 cases of immune rejection (later cured), and 3 cases of fracture. Conclusions Allogeneic bone promotes osteogenesis and bone defect repair with low incidence of immune rejection. Under the premise of complete resection of the bone tumor and comprehensive application of physical and chemical method to deal with the tumor boundary, satisfactory results can be achieved by allogeneic bone grafting.

关 键 词：同种异体移植物 骨肿瘤 肿瘤复发 局部 预后 

分 类 号：R738.1[医药卫生—肿瘤]