人工骨联合自体骨髓移植技术的骨缺损修复研究与应用  

The study and application of bone defect repair by artificial bone jointing autologous bone marrow transplantation technology

作　　者：王路[1] 郑杰[1] 徐浩[1] 

机构地区：[1]浙江省舟山医院,舟山316004

出　　处：《浙江创伤外科》2014年第4期515-518,共4页Zhejiang Journal of Traumatic Surgery

基　　金：浙江省舟山市2010年度科技计划项目(编号10140)

摘　　要：目的分析人工骨联合自体骨髓移植技术治疗骨缺损的临床疗效。方法选取2011年4月至2013年9月,来本院诊治的四肢粉碎性骨折术后骨缺损患者40例,随机分为两组（A、B组）,分别行自体髂骨植骨和人工骨联合自体骨髓移植治疗四肢粉碎性骨折所致骨缺损。术后观察两组骨折愈合时间,骨折愈合率,并发症的发生及骨缺损的修复和功能重建优良率。结果两组均行6～12个月随访,平均（9.14±1.36）月,所有患者植骨术后均无切口感染、发热等并发症。A组15例骨缺损区愈合良好,住院时间平均（19.36±2.54）天,骨折愈合时间平均（5.67±1.52）个月,骨缺损的修复和功能重建评价标准,优12例,良3例,可3例,差2例,优良率75%;B组18例骨缺损区愈合良好,住院时间平均（12.19±1.52）天,骨折愈合时间平均（3.61±1.13）个月,骨缺损的修复和功能重建评价标准,优16例,良2例,可2例,差0例,优良率90%。B组骨缺损治疗效果显著优于A组。结论人工骨联合自体骨髓移植较单纯自体髂骨移植治疗骨缺损更能促进骨痂生长,加速骨折后骨缺损愈合,更加有效地减少住院时间及骨折愈合时间,骨折愈合率更高,骨缺损修复和功能重建效果更加显著。Objective To analyze the clinical effects of treating bone defect by artificial bone jointing autologous bone marrow transplantation technology. Methods Selected 40 cases of bone defect patients with bone defect after limb comminuted fracture operation that were diagnosed in our hospital from April, 2011 to September, 2013 and were randomly into two groups（Group A and Group B）. In group A, patients were treated with autologous iliac crest graft and in group B,treated with artificial bone jointing autologous bone marrow transplantation. The healing time, fracture heal-ing rate, the occurrence of complications and repair of bone defect and function reconstruction good rate of these two groups after operation were ob-served. Results All patients were follow-uped for 6-12 months, average 9.14±1.36 months. There was no complication of incision infection, fever after operation. In group A, 15 cases had good healing in bone defect area, the lengths of stay were averagely 19.36 ±2.54 d, and the bone healing time was averagely 5.67±1.52 months. According to the restoration and function reconstruction evaluation criteria of bone defect, 12 cases were excellent, 3cases good, 3 cases qualified, 2 cases bad, and the good rate was 75%. In group B, 18 cases had good healing in bone defect area, the lengths of stay were average 12.19±1.52 d, and the bone healing time was average 3.61±1.13 months. According to the restoration and function reconstruction evaluation criteria of bone defect, 16 cases were excellent, 2 cases good, 2 cases qualified, 0 cases bad, and the good rate was 90%. The bone defect treat-ment in group B is evidently better than that of group A. Conclusion comparing with the autologous iliac crest graft, bone defect treated with artificial bone jointing autologous bone marrow transplantation was better promote the growth of callus, accelerated the bone defect healing and reduce the length of stay and bone healing time.

关 键 词：骨折 骨缺损 人工骨 自体髂骨 骨髓移植 

分 类 号：R687.3[医药卫生—骨科学]