铰刀-灌洗-抽吸技术在骨缺损植骨中的应用研究进展  

Reamer-irrigator-aspirator technique in bone grafting for bone defects

作　　者：买吾拉江·麦麦江 祖丽胡马尔·艾合麦提 Maiwulajiang Maimaijiang;Zulihumar Aihemeiti(Orthopedics Department of Xinjiang Urumqi International Hospital,Urumqi 830000,China;Department of Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]乌鲁木齐国际医院骨科,乌鲁木齐830000 [2]新疆医科大学第一附属医院重症医学科,乌鲁木齐830000

出　　处：《创伤外科杂志》2023年第9期715-719,共5页Journal of Traumatic Surgery

摘　　要：骨缺损的治疗包括骨移植术、Masquelet技术、骨搬移等,自体骨移植仍是骨缺损治疗的金标准。自体骨的获取方法主要在髂骨嵴处。铰刀-灌洗-抽吸(reamer-irrigator-aspirator,RIA)装置可获取大量移植骨用于骨缺损处填充。相比较髂骨嵴取骨,通过RIA技术获取的移植骨滤液样本中含有大量促成骨因子,能加速骨质愈合。术前放射学评估髓腔直径对选择粗细合适的扩髓钻头有重大意义。相比自体髂取骨移植,RIA技术具有供区创伤小、移植骨量多(每次取骨最大量为90mL)、手术时间短、植骨区愈合时间短、术后疼痛评分低等优点,也存在供区骨干穿孔或骨折、术中大出血、费用高等不足。目前RIA技术在临床应用时间较短,仍需长期多中心、大量本、随机对照研究证实其疗效。The treatment strategies for bone defects include bone grafting,Masquelet technique,bone transport,etc.Among them,autogenous bone grafting is still the gold standard.Autogenous bone is mainly obtained from the iliac crest.The reamer-irrigator-aspirator(RIA)device can obtain a large number of bone grafts to fill the defects.Compared with iliac crest bone harvesting,the filtrate of bone grafts sampled by RIA technique contains a large number of osteogenic factors,which can accelerate bone healing.Preoperative radiological evaluation of the diameter of the medullary cavity is of great significance for the selection of a suitable reamer bit.Compared with autologous iliac bone grafting,RIA technique has the advantages of less trauma in the donor area,more bone grafts(maximally 90 mL each time),shorter operation and healing time in the grafting area,and less postoperative pain.However,the RIA technique still has the disadvantages of bone perforation or fracture at the donor site,massive intraoperative bleeding and high cost.As RIA is newly applied in clinic,its effect needs to be verified by long-term multicenter randomized controlled studies with large sample size.

关 键 词：骨缺损 RIA技术 植骨 

分 类 号：R683[医药卫生—骨科学]