人工骨一期植骨治疗开放性掌骨损伤的临床效果分析  

Analysis of clinical effect by artificial bone primary graft of bone in the treatment of open metacarpal bone injury

作　　者：杨燎北 叶斌 周敏 魏碧霞 潘永良 陈建球 

机构地区：[1]广东省东莞市企石医院手外科,523500

出　　处：《中国实用医药》2016年第18期18-19,共2页China Practical Medicine

摘　　要：目的研究探讨人工骨一期植骨治疗开放性掌骨损伤的临床效果。方法 59例开放性掌骨损伤患者,其中19例采用内固定联合一期自体骨移植治疗记为自体组,18例采用内固定联合一期异体骨移植治疗记为异体组,22例采用内固定联合人工骨一期植骨治疗记为人工组。三组手术时均行彻底清创,若患者皮肤软组织损伤需行邻位皮瓣移植恢复治疗。术后对三组患者进行随访,并记录统计患者恢复情况与临床满意率。结果三组患者皮瓣移植均一期存活,创面愈合,术后随访7~20个月,自体组、异体组、人工组平均随访时长分别为（11.86±2.17）、（12.41±2.19）、（10.96±2.09）个月;术后患者骨缺损处均痊愈,痊愈时长2~3个月,自体组、异体组、人工组平均痊愈时长分别为（2.06±0.21）、（2.35±0.17）、（1.99±0.21）个月。三组上述时长比较差异无统计学意义（P〉0.05）。自体组出现取骨手术相关并发症1例,异体组出现免疫排斥反应1例,经对症处理后均好转,无后遗症。自体组对此次手术治疗临床满意率为95%,异体组为67%,人工组为95%。自体组、人工组临床满意率高于异体组,差异具有统计学意义（P〈0.05）。结论采用内固定联合人工骨一期植骨能有效治疗开放性掌骨损伤,病程缩短,并发症发生几率降低,减少伤痛给患者带来的痛苦,手术时行彻底清创及邻位皮瓣移植恢复治疗能有效减少患者伤口感染,是手术成功的关键之一。Objective To research and investigate clinical effect by artificial bone primary graft of bone in the treatment of open metacarpal bone injury. Methods Among 59 patients with open metacarpal bone injury, 19 cases as autologous group received internal fixation combined with autologous bone primary graft, 18 cases as allogeneic group received internal fixation combined with allogeneic bone primary graft, and 22 cases as artificial group received internal fixation combined with artificial bone primary graft. All groups received radical debridement, as well as necessary skin flap transplantation. Postoperative follow-up was taken to record rehabilitation and clinical satisfaction rate. Results Skin flap transplantation for all three groups showed primary survival and healed wound. Follow-up was made in three groups for 7~20 months, with mean follow-up time respectively as（11.86±2.17）,（12.41±2.19） and（10.96±2.09） months in autologous group, allogeneic group and artificial group. All patients had healed bone defect after operation, with healing time as 2~3 months. Mean healing times in autologous group, allogeneic group and artificial group were respectively（2.06±0.21）,（2.35±0.17） and（1.99±0.21） months. There was no statistically significant difference across the three groups（P〉0.05）. Autologous group had 1 case with graft surgery-related complication, and allogeneic group had 1 case with immunological rejection. Both cases were cured after symptomatic therapy without sequela. Clinical satisfaction rates was 95% in autologous group, and that was 67% in allogeneic group and 95% in artificial group. Autologous group and allogeneic group had higher clinical satisfaction rate than allogeneic group, and the difference had statistical significance（P〈0.05）. Conclusion Combination of internal fixation and artificial bone primary graft can effective treat open metacarpal bone injury, along with shortened course, reduced incidence of complications, and relieved pain in patients. As one o

关 键 词：开放性掌骨损伤 人工骨 临床效果 

分 类 号：R687.3[医药卫生—骨科学]