硫酸钙颗粒结合同种异体植骨术后高压氧治疗对四肢良性骨肿瘤缺损重建的影响  

Effects of hyperbaric oxygen therapy on the reconstruction of benign bone tumors of the limbs after allogeneic bone grafting combined with calcium sulfate pellets

作　　者：王培芹 孙冰 王光达 Wang Peiqin;Sun Bing;Wang Guangda(Department of Orthopedics,South Brunch,Yantai Mountain Hospital,Yantai 264000,China)

机构地区：[1]烟台山医院南院骨科,山东省烟台264000 [2]毓璜顶医院关节骨科

出　　处：《中华航海医学与高气压医学杂志》2021年第3期288-292,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：烟台市科技计划资助项目(201803011)。

摘　　要：目的探讨硫酸钙颗粒结合同种异体植骨术后高压氧(HBO)治疗四肢良性骨肿瘤患者的临床疗效。方法收集2013年7月至2019年7月烟台山医院骨科和毓璜顶医院关节骨科行植骨重建修复术的129例四肢良性骨肿瘤患者的临床资料。按照治疗方法分为3组,A组(n=42)采用同种异体植骨术治疗;B组(n=40)采用硫酸钙颗粒结合同种异体植骨术治疗;C组(n=47)采用硫酸钙颗粒结合同种异体植骨术后联合HBO治疗。比较3组患者治疗后的临床疗效,记录3组患者术后颗粒完全吸收时间、骨愈合时间及遗留骨缺损数量;统计3组患者治疗后切口引流量和软组织肿胀消失时间。在治疗前及治疗后1、3个月行X线检查,计算3组患者良性骨肿瘤X线最大横径;采用双能X线骨密度测量仪检测3组患者治疗前及治疗后1、3个月骨密度。结果患者治疗后总有效率B组(72.5%)、C组(85.1%)明显高于A组(57.1%),C组明显高于B组,差异均有统计学意义(P<0.05)。B、C组患者软组织肿胀消失时间和切口引流量均明显短于和少于A组,C组患者软组织肿胀消失时间和切口引流量明显短于和少于B组,差异均有统计学意义(P<0.05)。B、C组患者硫酸钙颗粒完全吸收时间、骨愈合时间及遗留骨缺损率明显短于和低于A组,C组患者颗粒完全吸收时间、骨愈合时间及遗留骨缺损率明显短于和低于B组,差异均有统计学意义(P<0.05或P<0.01)。术后3个月,B、C组患者骨密度明显高于A组,骨肿瘤X线最大横径明显小于A组,C组骨密度明显高于B组,骨肿瘤X线最大横径明显小于B组,差异均有统计学意义(P<0.05)。结论硫酸钙颗粒联合同种异体植骨术后HBO治疗能减轻组织水肿,提高病灶处骨密度,促进骨质愈合,临床疗效显著,有利于良性骨肿瘤植骨术后骨缺损的重建。Objective To investigate the clinical effects of hyperbaric oxygen(HBO)therapy in the treatment of benign bone tumors of the extremities after calcium sulfate pellets combined allogeneic bone grafting.Methods The clinical data of 129 patients with benign bone tumors of the extremities who underwent bone grafting reconstruction at the Department of Orthopedics of Yantai Mountain Hospital and the Department of Orthopedics(Bone Joints)of Yantai Yuhuangding Hospital between July 2013 and July 2019 were selected and divided into three groups:group A(n=42 cases)was treated with allogeneic bone grafting;group B(n=40 cases)was treated with calcium sulfate pellets combined with allogeneic bone grafting;and group C(n=47 cases)was treated with post-grafting HBO in addition to calcium sulfate pellets combined with allogeneic bone grafting.The clinical outcomes of the three groups were compared.The time of complete absorption and bone healing as well as the quantity of remaining bone defects were recorded.The incision drainage volume and the time when soft tissue swelling disappeared were also noted.X-ray examination was performed before treatment and 1 and 3 months after treatment to calculate the maximum X-ray transverse diameters of benign bone tumors in the three groups.Bone mineral density(BMD)was measured by a dual energy X-ray absorptiometry before treatment and 1 and 3 months after treatment in the three groups.Results After the treatment,the total effective rates of the group B(72.5%)and the group C(85.1%)were significantly higher than that of the group A(57.1%).The rate of the group C was significantly higher than that of the group B(P<0.05).The disappearance time of soft tissue swelling and incision drainage volume in the group B and the group C were significantly shorter and lower than those in the group A;while the time of soft tissue swelling disappearance and incision drainage volume in the group C were significantly shorter and lower than those in the group B(P<0.05).The complete absorption time,bone healing t

关 键 词：良性骨肿瘤 硫酸钙颗粒 同种异体骨 高压氧 植骨 重建 

分 类 号：R738.1[医药卫生—肿瘤]