经皮自体骨髓移植治疗胫骨骨折延迟愈合及不愈合的临床研究  

Clinical Study of Delayed Union and Nonunion of Tibial Fracture Treated by Percutaneous Autogenous Bone Marrow Transplantation

作　　者：周英勇[1] 程少文[2] 安涛[1] 陈克伟[1] 李红波[2] 彭磊[1,2] 

机构地区：[1]温州医科大学附属第二医院骨科,325000 [2]海南医学院附属医院创伤中心,海口570102

出　　处：《医学研究杂志》2016年第3期22-25,共4页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81460339);海南省重大科技项目(ZDZX2013003)

摘　　要：目的 探讨经皮自体骨髓移植治疗胫骨骨折延迟愈合、不愈合的疗效.方法 按同一标准选取胫骨骨折延迟愈合、不愈合患者,治疗组30例,对照组28例,治疗组采用经皮自体骨髓移植技术治疗,对照组采用自体髂骨植骨治疗,术后均随访摄X线片,评估骨折愈合情况.结果 全部病例获得随访,随访时间为4~24个月,平均随访时间为12个月.治疗组中27例患者愈合良好,3例不愈合;对照组中26例愈合良好,2例不愈合.治疗组、对照组有效率分别为90.0%、92.9%,有效率相接近.依照疗效评价标准,对两组患者不同愈合程度骨痂形成时间进行比较（P均〉0.05）,疗效达4个阶段所需平均时间差异无统计学意义（P〉0.05）,因此,可以认为两组患者疗效无差别.结论 经皮自体骨髓移植治疗胫骨骨折延迟愈合、不愈合疗效满意, 是临床上值得推广应用的方法.Objective To investigate the effect of percutaneous autogenous bone marrow transplantation in the treatment of delayed union and nonunion of tibial fracture. Methods According to the same criteria, the delayed union and nonunion of tibial fractures were selected, including 30 cases in treatment group and 28 cases in control group. The treatment group was treated by percutaneous autologous bone marrow transplantation, and the control group was treated with autologous iliac bone graft. All the patients were followed up for X-ray examination, and the fracture healing was evaluated. Results All cases were followed up for 4 to 24 months, with an average of 12 months. In the treatment group, 27 patients were healed, 3 cases did not heal, while in the control group, 26 cases were healed, 2 cases were not healed.The success rate of the treatment group and control group were 90.0%, 92.9% respectively, and the success rate was close to each other. According to the evaluation standard of curative effect, the time of callus formation in two groups of patients were compared, and P values were more than 0.05, and there was no significant difference in the average time between the 4 stages.Therefore,it can be considered that there is no difference between the two groups in the treatment effect. Conclusion The treatment of delayed union and nonunion of tibial fracture by percutaneous autologous bone marrow transplantation is satisfactory, and it is worthy of clinical application.

关 键 词：自体骨髓 移植 胫骨骨折 骨折不愈合 延迟愈合 

分 类 号：R6[医药卫生—外科学]