同种异体骨移植术修复重建四肢恶性骨肿瘤切除后骨缺损的临床效果  

Clinical effect of allogeneic bone transplantation in repairing and reconstructing bone defects after resection of malignant bone tumors of extremities

作　　者：周忠 刘传华 朱丰田 吕卫星 ZHOU Zhong;LIU Chuanhua;ZHU Fengtian;LYU Weixing(Orthopaedics Surgery Department,Xianning First People's Hospital,Xianning 437000,China;Oncology Department,Xianning First People's Hospital,Xianning 437000,China)

机构地区：[1]咸宁市第一人民医院骨外科,湖北咸宁437000 [2]咸宁市第一人民医院肿瘤科,湖北咸宁437000

出　　处：《临床医学研究与实践》2025年第5期65-68,共4页Clinical Research and Practice

摘　　要：目的分析同种异体骨移植术修复重建四肢恶性骨肿瘤切除后骨缺损的临床效果。方法选取2021年9月至2024年2月我院收治的60例四肢恶性骨肿瘤切除后骨缺损患者为研究对象,所有患者均接受同种异体骨移植术修复重建治疗。统计患者术后随访1年的不良事件发生情况;比较患者术前、术后3个月的骨生化指标、免疫功能及肢体功能。结果60例患者术后1年内均未发生移植异体骨或假体周围骨折、关节脱位、假体松动等情况。在术后第3个月复诊时,有2例发生骨不愈合情况,经过内固定部分取出及自体骨植骨治疗后有所好转,并在10个月内完全愈合。术后3个月,患者的β-胶原降解产物(β-CTX)、骨生长蛋白(BGP)、骨碱性磷酸酶(BALP)及抗酒石酸盐酸性磷酸酶异构体5b(TRACP-5b)水平显著低于术前,骨钙素N端中分子片段(N-MID)水平显著高于术前,差异具有统计学意义(P<0.05)。术后3个月,患者的免疫球蛋白A(IgA)、免疫球蛋白G(IgG)及免疫球蛋白M(IgM)水平显著低于术前,骨骼肌肉系统肿瘤协会(MSTS)评分显著高于术前,差异具有统计学意义(P<0.05)。结论同种异体骨移植术修复重建四肢恶性骨肿瘤切除后骨缺损的效果显著,能够改善患者的骨生化指标、免疫功能及肢体功能,且不会发生严重不良事件。Objective To analyze the clinical effect of allogeneic bone transplantation in repairing and reconstructing bone defects after resection of malignant bone tumors of extremities.Methods A total of 60 patients with bone defects after resection of malignant bone tumors of extremities admitted in our hospital from September 2021 to February 2024 were selected as the research objects.All patients received allogeneic bone transplantation for repair and reconstruction.The incidence of adverse events of patients during 1 year follow-up was counted;the bone biochemical indexes,immune function and limb function of patients before operation and at 3 months after operation were compared.Results No allograft bone or periprosthetic fracture,joint dislocation or prosthesis loosening occurred in 60 patients within 1 year after operation.At the third month after the operation,2 cases of bone nonunion occurred,which was improved after the removal of the internal fixation and the treatment of autologous bone grafting,and completely healed within 10 months.At 3 months after operation,the levels ofβ-C-terminal telopeptide of type-Ⅰcollagen(β-CTX),bone growth protein(BGP),bone alkaline phosphatase(BALP)and tartrate resistant acid phosphatase 5b(TRACP-5b)in patients were significantly lower than those before operation,and the level of N terminal mid-fragment of osteocalcin(N-MID)was significantly higher than that before operation,the differences were statistically significant(P<0.05).At 3 months after operation,the levels of immunoglobulin A(IgA),immunoglobulin G(IgG)and immunoglobulin M(IgM)in patients were significantly lower than those before operation,and the score of Musculoskeletal Tumor Society(MSTS)was significantly higher than that before operation,the differences were statistically significant(P<0.05).Conclusion Allogeneic bone transplantation is effective in repairing and reconstructing bone defects after resection of malignant bone tumors of extremities.It can improve bone biochemical indexes,immune function and limb fu

关 键 词：四肢恶性骨肿瘤 骨缺损 同种异体骨移植术 修复重建 

分 类 号：R738.1[医药卫生—肿瘤]