自体骨髓富集骨修复技术临床应用专家共识(2023版)  

Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair(version 2023)

作　　者：中华医学会骨科学分会 邢军超 毕龙 陈林 董世武 高梁斌[6] 侯天勇 侯志勇[7] 黄伟[8] 靳慧勇 李岩 李忠海[11] 刘鹏 刘曦明 罗飞 马锋[13] 沈杰 宋锦璘[14] 唐佩福[15] 吴新宝[16] 徐宝山[17] 许建中 徐永清 颜滨[19] 杨鹏 叶青 殷国勇[22] 于腾波[23] 曾建成[24] 张长青[25] 张英泽[7] 张泽华 赵枫 周跃 朱芸[28] 邹俊[29] Chinese Orthopaedic Association;Xing Junchao;Bi Long;Chen Li;Dong Shiwu;Gao Liangbin;Hou Tianyong;Hou Zhiyong;Huang Wei;Jin Huiyong;Li Yan;Li Zhonghai;Liu Peng;Liu Ximing;Luo Fei;Ma Feng;Shen Jie;Song Jinlin;Tang Pejfu;Wu Xinbao;Xu Baoshan;Xu Jianzhong;Xu Yongqing;Yan Bin;Yang Pen;Ye Qing;Yin Guoyong;Yu Tengbo;Zeng Jiancheng;Zhang Changqing;Zhang Yingze;Zhang Zehua;Zhao Feng;Zhou Yue;Zhu Yun;Zou Jun(不详;First Affiliated Hospital of Army Medical University,Chongqing 400038,China;First Affiliated Hospital of Air Force Medical University,Xi’an 710032,China;Daping Hospital,Army Medical University,Chongqing 400042,China;Army Medical University,Chongqing 400038,China;Second Affiliated Hospital of Sun Yat-sen University,Guangzhou 510120,China;Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;PLA 63790 Military Hospital,Liangshan 615012,China;Second Affiliated Hospital of Xi’an Medical College,Xi’an 710077,China;First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;General Hospital of Central War Zone of PLA,Wuhan 430012,China;People’s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Stomatological Hospital of Chongqing Medical University,Chongqing 400015,China;General Hospital of PLA,Beijing 100853,China;Beijing Jishuitan Hospital,Beijing 100035,China;Tianjin Hospital,Tianjin 300329,China;th Hospital of PLA Joint Logistics Support Force,Kunming 650118,China;Shenzhen Second People’s Hospital,Shenzhen 518025,China;Army 79th Group Military Hospital,Liaoyang 111010,China;Armed Police Force Guangxi General Hospital,Nanning 530003,China;Jiangsu Provincial People’s Hospital,Nanjing 210029,China;Affiliated Hospital of Qingdao University Medical College,Qingdao 266003,China;West China Hospital of Sichuan University,Chengdu 610041,China;Shanghai Sixth People’s Hospital,Shanghai 201306,China;th Hospital of PLA Joint Logistics Support Force,Quanzhou 362000,China;Second Affiliated H

机构地区：[1]不详 [2]陆军军医大学第一附属医院,重庆400038 [3]空军军医大学第一附属医院,陕西西安710032 [4]陆军军医大学大坪医院,重庆400042 [5]陆军军医大学,重庆400038 [6]中山大学附属第二医院,广东广州510120 [7]河北医科大学第三医院,河北石家庄050051 [8]重庆医科大学附属第一医院,重庆400016 [9]解放军63790部队医院,四川凉山615012 [10]西安医学院第二附属医院,陕西西安710077 [11]大连医科大学附属第一医院,辽宁大连116011 [12]解放军中部战区总医院,湖北武汉430012 [13]宁夏回族自治区人民医院,宁夏回族自治区银川750002 [14]重庆医科大学附属口腔医院,重庆400015 [15]中国人民解放军总医院,北京100853 [16]北京积水潭医院,北京100035 [17]天津医院,天津300329 [18]解放军联勤保障部队第九二○医院,昆明650118 [19]深圳市第二人民医院,广东深圳518025 [20]陆军第七十九集团军医院,辽宁辽阳111010 [21]武装警察部队广西总队医院,广西南宁530003 [22]江苏省人民医院,江苏南京210029 [23]青岛大学医学院附属医院,山东青岛266003 [24]四川大学华西医院,四川成都610041 [25]上海市第六人民医院,上海201306 [26]解放军联勤保障部队第九一○医院,福建泉州362000 [27]陆军军医大学第二附属医院,重庆400037 [28]重庆大学附属涪陵医院,重庆涪陵408099 [29]苏州大学附属第一医院,江苏苏州215006

出　　处：《中华卫生应急电子杂志》2023年第3期129-141,共13页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：重庆英才项目(cstc2022ycjh-bgzxm0104);军队后勤重大项目(AWS17J004-02-07);陆军装备综合研究科学研究项目(LJ20222Z060059)。

摘　　要：由创伤、骨感染等原因造成的骨缺损临床十分常见且治疗困难,通常需要骨移植材料进行修复。目前临床常用的骨移植材料主要包括自体骨、同种异体骨、异种骨、人工合成材料等,而自体骨以外的骨移植材料均存在不同程度的成骨活性不足。骨髓中含有干细胞、细胞因子等利于成骨的有效成分,基于高效骨髓利用的骨髓富集骨修复技术应运而生,其核心理念是将自体骨髓中具有促成骨作用的细胞和细胞因子浓聚于支架材料,快速构建为具有高成骨活性的骨移植材料。但该技术的临床适用范围、应用方法、安全性、有效性等尚缺乏科学指导和应用规范。为此,由中华医学会骨科学分会牵头,依据循证医学方法制订了《自体骨髓富集骨修复技术临床应用专家共识(2023版)》,主要从常用自体骨髓促进骨修复临床技术特点、自体骨髓富集骨修复技术适用范围、安全性和应用注意事项等方面提出相应的推荐意见,为规范该技术的临床应用提供指导。Bone defects caused by different causes such as trauma,severe bone infection and other factors are common in clinic and difficult to treat.Usually,bone substitutes are required for repair.Current bone grafting materials used clinically include autologous bones,allogeneic bones,xenografts,and synthetic materials,etc.Other than autologous bones,the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus.Bone marrow contains various components such as stem cells and bioactive factors,which are contributive to osteogenesis.In response,the technique of bone marrow enrichment,based on the efficient utilization of components within bone marrow,has been risen,aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity.However,the scientific guidance and application specification are lacked with regard to the clinical scope,approach,safety and effectiveness.In this context,under the organization of Chinese Orthopedic Association,the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair(version 2023)is formulated based on the evidence-based medicine.The consensus covers the topics of the characteristics,range of application,safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations,hoping to provide better guidance for clinical practice of the technique.

关 键 词：骨髓 骨移植 骨生成 骨移植材料 

分 类 号：R318.08[医药卫生—生物医学工程]