长骨大段骨缺损修复方法的优势与不足  

Advantages and disadvantages of repairing large-segment bone defect

作　　者：邢浩 张永红[2] 王栋[2] Xing Hao;Zhang Yonghong;Wang Dong(Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Department of Orthopedics,Second Hospital,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学,山西省太原市030001 [2]山西医科大学第二医院骨科,山西省太原市030001

出　　处：《中国组织工程研究》2021年第3期426-430,共5页Chinese Journal of Tissue Engineering Research

基　　金：山西省社会发展基金(201803D31126),项目负责人:张永红。

摘　　要：背景:长骨大段骨缺损的治疗一直是骨科临床上面临的一大难题,大段骨缺损的治疗有着治疗时间长、难度大、费用高的问题,因此研究长骨大段骨缺损的治疗方案具有重要的临床价值及意义。目的:就当前应用的修复长骨大段骨缺损的方法及各自优势与不足进行综述。方法:第一作者应用计算机检索至2020年4月为止PubMed、CNKI及万方数据库,以"bone defect,bone repair,bone graft,intramedullary nail technology,Masquelet,bone transport,vascularized bone graft,bone tissue engineering"为英文检索词,以"骨缺损,骨修复,骨移植,髓内钉技术,膜诱导技术,骨搬移,带血管蒂骨移植,骨组织工程"为中文检索词。最终纳入符合标准的40篇文献,并以此对修复长骨大段骨缺损的方法及各自的优势与不足作一综述。结果与结论:①当前对大段骨缺损的范围没有明确定义,临床中可以根据经验将长度较长、愈合能力较差、传统固定加自体骨移植方法难以愈合的骨缺损视为大段骨缺损;②现有的修复方案众多,不同的方法都可以在治疗过程中发挥独特优势,但在选择治疗方法时要注意不同方法的缺点及相关并发症,提高骨愈合率;③仍需改善和规范现有长骨大段骨缺损的治疗技术来获得更加满意的治疗效果。BACKGROUND:The treatment of large-segment bone defect has always been a major problem in clinical orthopedics.The treatment of large-segment bone defect is characterized by long treatment time,high difficulty and high cost.Therefore,it is of great clinical value and significance to study the treatment of large-segment bone defect.OBJECTIVE:To review the current methods of repairing large-segment bone defect and their advantages and disadvantages.METHODS:PubMed,CNKI and Wanfang databases before April 2020 were retrieved by the first author with the keywords of“bone defect,bone repair,bone graft,intramedullary nail technology,Masquelet,bone transport,vascularized bone graft,bone tissue engineering”in English and Chinese,respectively.Forty eligible articles were included to systematically summarize the repair methods and their advantages and disadvantages in the treatment of large-segment bone defect.RESULTS AND CONCLUSION:(1)Currently,the scope of large bone defects is not clearly defined.In clinical practice,long bone defects with poor healing ability and difficult healing by traditional fixation and autogenous bone graft can be regarded as large-segment bone defect according to experience.(2)There are many repair methods,and different methods can play their unique advantages in the treatment process.However,the disadvantages and related complications of different methods should be paid attention to when choosing the treatment method,so as to improve the bone healing rate.(3)It is still necessary to improve and standardize the existing treatment technology of large-segment bone defect to obtain a more satisfactory treatment effect.

关 键 词：骨缺损 大段 骨修复 骨移植 髓内钉 骨搬移 血管蒂 组织工程 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]