个体化组织工程骨与同种异体骨修复人长骨缺损的临床疗效和安全性对比  

Comparison on clinical efficacy and safety of individualized tissue-engineered bone and allogenic bone in repairing human long bone defects

作　　者：冯晓东[1] 程芳芳[1] 郭军[1] 王喜良[1] 周荣兴[1] FENG Xiao-dong;CHENG Fang-fang;GUO Jun;WANG Xi-liang;ZHOU Rong-xing(Second Department of Traumatology,Second Affiliated Hospital of Inner Mongolia Medical University,Huhhot Inner Mongolia 010030,China)

机构地区：[1]内蒙古医科大学第二附属医院创伤二科,内蒙古呼和浩特010030

出　　处：《局解手术学杂志》2020年第11期883-889,共7页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较个体化组织工程骨与同种异体骨修复人长骨缺损的临床疗效和安全性。方法收集2010年3月至2015年2月因四肢长骨缺损于我院行个体化组织工程骨或同种异体骨植入的62例患者的临床资料,其中个体化组织工程骨植入32例(观察组),同种异体骨植入30例(对照组),比较2组患者的临床疗效、安全性及血液学指标。结果观察组骨愈合时间短于对照组,差异有统计学意义(P<0.05)。2组患者术后2 d体温和局部皮肤温度均较术前升高,且对照组高于观察组,差异均有统计学意义(P<0.05)。对照组术后2 d患肢植骨区周径大于术前和观察组,差异均有统计学意义(P<0.05)。与术前相比,2组患者术后1周尿酸(UA)、肌酐(Cr)、血沉(ESR)、白细胞计数(WBC)、中性粒细胞百分比(NEU%)、淋巴细胞百分比(NLR)、C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、免疫黏附抑制因子(FEIR)以及免疫复合物花环率(RBC-ICR)均升高,白介素-4(IL-4)、转化生长因子-β(TGF-β)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫黏附促进因子(RFER)以及红细胞C3b受体花环率(RBC-C3bR)均降低,且观察组升高/降低幅度小于对照组,差异均有统计学意义(P<0.05)。以上指标术后1~18个月随访中虽有波动但均逐渐恢复至术前水平。结论个体化组织工程骨修复人长骨缺损较同种异体骨成骨能力更优异,骨愈合时间明显较短,其近中长期的生物安全性更可靠。Objective To compare the clinical efficacy and safety of individualized tissue-engineered bone and allogenic bone in repairing human long bone defects.Methods The clinical data of 62 patients with long bone defects of limbs treated by individualized tissue engineered bone graft and allogenic bone graft in our hospital from March 2010 to February 2015 were collected,of which 32 patients were treated by individualized tissue-engineered bone graft (the observation group),and 30 cases were treated by allogenic bone graft (the control group). The clinical efficacy,safety and hematological indexes between the two groups were compared. Results The time of bone healing in the observation group was shorter than that in the control group,and the difference was statistically significant ( P <0.05). The body temperature and local skin temperature of the patients 2 days after surgery in the two groups were higher than those before surgery,and the body temperature and local skin temperature in the control group was higher than those in the observation group,the differences were statistically significant ( P <0.05). The circumference of the bone graft area in the control group was larger than those before operation and in the observation group,and the differences were statistically significant ( P <0.05).The levels of uric acid (UA),creatinine (Cr),erythrocyte sedimentation rate(ESR),white blood cell count(WBC),neutrophils percentage (NEU%),neutrophil to lymphocyte ratio(NLR), C-reactive protein (CRP),interleukin-6(IL-6),tumor necrosis factor-α ( TNF-α ),rosette forming inhibitor rate (FEIR),and red blood cell immune complex rate( RBC-ICR ) 1 week after operation were all higher than those before operation ,interleukin-4(IL-4),transforming growth factor-β (TGF-β),immunoglobulinA(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM),rosette forming enhancement rate (RFER),and red blood cell-C3bR rosette rate(RBC-C3bR) were all lower than those before operation,and the increasing and decreasing range in the observation group wer

关 键 词：个体化组织工程骨 同种异体骨 长骨缺损 临床疗效 安全性 骨缺损修复 骨移植材料 

分 类 号：R683.4[医药卫生—骨科学]