干细胞富集人工骨治疗儿童骨缺损的系列病例研究  

A series of case studies on the treatment of bone defects in children with enriched stem cell-loaded artificial bone

作　　者：刘相 王国梁 王虎 刘云燕 李晨宇 王超丽 张云飞 LIU Xiang;WANG Guoliang;WANG Hu;LIU Yunyan;LI Chenyu;WANG Chaoli;ZHANG Yunfei(Department of Orthopaedics,Tangdu Hospital,Air Force Medical University,Xi'an 710038,China;School of Pharmacy,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学唐都医院骨科,陕西西安710038 [2]空军军医大学药学系,陕西西安710032

出　　处：《空军军医大学学报》2025年第3期378-385,共8页Journal of Air Force Medical University

基　　金：陕西省重点研发计划项目(2024SF2-GJHX-36)。

摘　　要：目的探讨术中即刻干细胞富集联合硫酸钙磷酸钙复合物人工骨治疗儿童骨缺损的临床效果。方法通过回顾空军军医大学唐都医院骨科2015年7月至2024年7月收治的11例骨缺损患儿,分析术中通过筛选富集组合循环系统将自体骨髓间充质干细胞(BMSCs)即刻富集于硫酸钙磷酸钙复合物人工骨进行治疗的可行性及优势,重点分析BMSCs在硫酸钙磷酸钙复合物人工骨颗粒的即刻富集效应及其针对儿童骨缺损的修复效果。采用Samantha X射线评分评估骨愈合。采用Paley评分法和SF-36评分法评价患者术前、术后邻关节功能和生活质量。结果体外实验显示人工骨生物相容性好,与人源BMSCs共培育一段时间后细胞活性理想;自体BMSCs在硫酸钙磷酸钙人工骨颗粒表面富集效率较高,用于治疗儿童骨缺损效果显著。本研究共收治11例患儿,随访时间(16.3±5.8)周。术后未见感染、出血、缺损修复失败、顽固性疼痛、骨折等相关并发症,骨缺损修复效果满意。结论术中将自体BMSCs即刻富集于硫酸钙磷酸钙复合物人工骨是一种成熟的临床技术,是用于儿童骨缺损修复的一种满意可行的方法。Objective To investigate the clinical efficacy of immediate intraoperative enrichment of stem cells combined with calcium sulfate-calcium phosphate composite artificial bone in the treatment of bone defects in children.Methods A retrospective analysis was conducted on 11 pediatric patients with bone defects admitted to the Department of Orthopaedics,Tangdu Hospital,Air Force Medical University from July 2015 to July 2024.The feasibility and advantages of integrating autologous bone marrow mesenchymal stem cells(BMSCs)into calcium sulfate-calcium phosphate composite artificial bone during surgery were analyzed.This was achieved through a screen-enrich-combine circulating system implemented intraoperatively.The immediate enrichment effect of BMSCs in calcium sulfate-calcium phosphate composite artificial bone particles and its repair effect on bone defects in children were analyzed.Bone healing was assessed utilizing Samantha X-ray scoring system.Additionally,the adjacent joint function and quality of life before and after surgery were evaluated by Paley score and SF-36 score.Results In vitro experiments demonstrated favorable biocompatibility of the artificial bone,with optimal cell viability after coculture with human BMSCs for an extended period.Autologous BMSCs exhibited high enrichment efficiency on the surface of calcium sulfate-calcium phosphate artificial bone particles,indicating its efficacy in the treatment of bone defects in children.A total of 11 pediatric patients were enrolled in this study,with a follow-up duration of(16.3±5.8)weeks.Postoperative observations revealed no complications such as infection,bleeding,repair failure,intractable pain,and fracture.The repair outcome of bone defects was deemed satisfactory.Conclusion Immediate intraoperative enrichment of autologous BMSCs into calcium sulfate-calcium phosphate composite artificial bone represents a mature clinical approach,which stands as a satisfactory and feasible method for bone defect repair in children.

关 键 词：儿童 骨缺损 干细胞富集 硫酸钙磷酸钙复合物 

分 类 号：R726.8[医药卫生—儿科]