中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2008年
7期
1368-1371
,共4页
同种异体骨%骨肿瘤%瘤样病变%骨缺损
同種異體骨%骨腫瘤%瘤樣病變%骨缺損
동충이체골%골종류%류양병변%골결손
背景:骨肿瘤及瘤样病变切刮后骨缺损取自体骨填充,由于取材量不能完全满足临床需要,且供骨区常遗有不同程度并发症,使其在临床应用中受到明显限制.异体骨以其结构及生物特性与自体骨相似、来源丰富、可以长期保存及使用方便等特点日益广泛地应用于临床.目的:观察同种异体骨用于填充修复良性骨肿瘤及瘤样病变切、刮除术后骨缺损后的生物相容性表现及临床应用效果.设计:回顾性分析.单位:内蒙古医学院第二附属医院骨肿瘤科、骨盆外科.对象:选择1999-12/2005-12在内蒙古医学院第二附属医院骨肿瘤科因良性骨肿瘤及瘤样病变行病灶刮除、高温灭活,冻干同种异体小块骨填充修复骨缺损的患者230例,男156例,女74例;年龄5～56岁.患者同意使用异体骨,并签订植入异体骨协议书;实验经医院伦理委员会批准.方法:①使用由由山西奥瑞生物材料有限公司/山西省医用组织库提供的同种异体骨填充修复骨缺损.对良性骨肿瘤及骨囊肿和骨纤维结构不良等行囊内刮除术,用同种异体骨填塞空腔.②根据Mankin等对同种骨移植结果的评分标准评估疗效,分为满意和不满意两个层次.于术后3,6和12个月对手术部位拍摄X射线平片,并平均随访38个月以观察疗效.主要观察指标:异体骨填充修复骨肿瘤骨缺损的组织相容性.结果:患者230例全部进入主要结果分析.①同种骨生物相容性:少数患者术后有轻度排异反应.该植入材料生物相容性好,可与植入部位患者骨组织直接进行融合,不阻止骨细胞在其表面的正常活性或干扰自体骨细胞的自然替代过程,即无免疫排斥反应或很小.所有病例在术后6～18个月达到骨性愈合,平均6.5个月.并发症:34例切口渗出淡黄色液体,其中30例于2周后切口愈合(14.8%);切口延期愈合4例(1.7%).②疗效:满意196例(85.2%),不满意34例(14.8%).结论:同种异体小块骨具有良好的组织相容性及成骨作用,是骨移植术中良好的植骨材料.
揹景:骨腫瘤及瘤樣病變切颳後骨缺損取自體骨填充,由于取材量不能完全滿足臨床需要,且供骨區常遺有不同程度併髮癥,使其在臨床應用中受到明顯限製.異體骨以其結構及生物特性與自體骨相似、來源豐富、可以長期保存及使用方便等特點日益廣汎地應用于臨床.目的:觀察同種異體骨用于填充脩複良性骨腫瘤及瘤樣病變切、颳除術後骨缺損後的生物相容性錶現及臨床應用效果.設計:迴顧性分析.單位:內矇古醫學院第二附屬醫院骨腫瘤科、骨盆外科.對象:選擇1999-12/2005-12在內矇古醫學院第二附屬醫院骨腫瘤科因良性骨腫瘤及瘤樣病變行病竈颳除、高溫滅活,凍榦同種異體小塊骨填充脩複骨缺損的患者230例,男156例,女74例;年齡5～56歲.患者同意使用異體骨,併籤訂植入異體骨協議書;實驗經醫院倫理委員會批準.方法:①使用由由山西奧瑞生物材料有限公司/山西省醫用組織庫提供的同種異體骨填充脩複骨缺損.對良性骨腫瘤及骨囊腫和骨纖維結構不良等行囊內颳除術,用同種異體骨填塞空腔.②根據Mankin等對同種骨移植結果的評分標準評估療效,分為滿意和不滿意兩箇層次.于術後3,6和12箇月對手術部位拍攝X射線平片,併平均隨訪38箇月以觀察療效.主要觀察指標:異體骨填充脩複骨腫瘤骨缺損的組織相容性.結果:患者230例全部進入主要結果分析.①同種骨生物相容性:少數患者術後有輕度排異反應.該植入材料生物相容性好,可與植入部位患者骨組織直接進行融閤,不阻止骨細胞在其錶麵的正常活性或榦擾自體骨細胞的自然替代過程,即無免疫排斥反應或很小.所有病例在術後6～18箇月達到骨性愈閤,平均6.5箇月.併髮癥:34例切口滲齣淡黃色液體,其中30例于2週後切口愈閤(14.8%);切口延期愈閤4例(1.7%).②療效:滿意196例(85.2%),不滿意34例(14.8%).結論:同種異體小塊骨具有良好的組織相容性及成骨作用,是骨移植術中良好的植骨材料.
배경:골종류급류양병변절괄후골결손취자체골전충,유우취재량불능완전만족림상수요,차공골구상유유불동정도병발증,사기재림상응용중수도명현한제.이체골이기결구급생물특성여자체골상사、래원봉부、가이장기보존급사용방편등특점일익엄범지응용우림상.목적:관찰동충이체골용우전충수복량성골종류급류양병변절、괄제술후골결손후적생물상용성표현급림상응용효과.설계:회고성분석.단위:내몽고의학원제이부속의원골종류과、골분외과.대상:선택1999-12/2005-12재내몽고의학원제이부속의원골종류과인량성골종류급류양병변행병조괄제、고온멸활,동간동충이체소괴골전충수복골결손적환자230례,남156례,녀74례;년령5～56세.환자동의사용이체골,병첨정식입이체골협의서;실험경의원윤리위원회비준.방법:①사용유유산서오서생물재료유한공사/산서성의용조직고제공적동충이체골전충수복골결손.대량성골종류급골낭종화골섬유결구불량등행낭내괄제술,용동충이체골전새공강.②근거Mankin등대동충골이식결과적평분표준평고료효,분위만의화불만의량개층차.우술후3,6화12개월대수술부위박섭X사선평편,병평균수방38개월이관찰료효.주요관찰지표:이체골전충수복골종류골결손적조직상용성.결과:환자230례전부진입주요결과분석.①동충골생물상용성:소수환자술후유경도배이반응.해식입재료생물상용성호,가여식입부위환자골조직직접진행융합,불조지골세포재기표면적정상활성혹간우자체골세포적자연체대과정,즉무면역배척반응혹흔소.소유병례재술후6～18개월체도골성유합,평균6.5개월.병발증:34례절구삼출담황색액체,기중30례우2주후절구유합(14.8%);절구연기유합4례(1.7%).②료효:만의196례(85.2%),불만의34례(14.8%).결론:동충이체소괴골구유량호적조직상용성급성골작용,시골이식술중량호적식골재료.
BACKGROUND: Bone defects forming after resection of bone tumor and tumor-like lesion are often packed with autogeneic bone. But sample amount cannot completely meet the clinical demand and different degrees of complications are often left in the bone graft donor region. All these problems remarkably limit the application of autogeneic bone. Allogenic bone is increasingly widely used in the clinical practice due to its structure and biological characteristics similar to autogeneic bone, rich sources, long-term preservation, easy to use and other advantages. OBJECTIVE: To investigate the biocompatibility and clinical application effects of allogeneic bone in filling and repairing benign bone tumor and tumor-like lesion after resection and curettage.DESIGN: A retrospective analysis. SETTING: Department of Pelvis Surgery, Second Affiliated Hospital of Inner Mongolia Medical College. PARTICIPANTS: Totally 230 patients (156 males and 74 females, with age of 5-56 years) were admitted to Department of Bone Tumor, Second Affiliated Hospital of Inner Mongolia Medical College from December 1999 to December 2005 to undergo curettage and hyperthermia inactivation due to benign bone tumor and tumor-like lesion and to receive the treatment by filling and repairing bone defects with lyophilized small-segment allogeneic bone, and were recruited for this study. Written informed consents of treatment were obtained from all the patients. The protocol was approved by the Hospital's Ethics Committee. METHODS: Allogeneic bone grafts (Shanxi Aorui Biomedical Co.,Ltd /Shanxi Provincial Medical Tissue Banking) were used to fill and repair bone defects. Patients who had benign bone tumor, bone cyst or osteofibrous dysplasia underwent cyst curretage. Allogeneic bones were used to pack empty cavity. Therapeutic effects were assessed according to the scoring criteria of allogeneic bone transplantation from Mankin et al, consisting of satisfactory and unsatisfactory two levels. X-ray plain films of surgery sites were taken at postoperative 3, 6 and 12 months. The patients were followed up for 38 months on average in order to observe the therapeutic effects. MAIN OUTCOME MEASURES: Histocompatibility of allogeneic bone in filling and repairing bone tumor defects. RESULTS: All 230 patients participated in the final analysis. ① Biocompatibility of allogeneic bone: Postoperatively, minority of patients had mild immunological rejections. Such allogeneic bone grafts had a good biocompatibility. They could directly fuse with bone tissue in the implantation location of patients, but not inhibit the normal activity of osteocytes on the allogeneic bone grafts or interfere the natural substitution of autogeneic osteocytes, i.e. there were no or less immunological rejections. Bone union was obtained in all the patients at postoperative 6-18 months (6.5 months on average). Thirty-four patients presented exudation of light yellow liquid from incision. Incisions healed in 30 (14.8%) patients at postoperative 2 weeks and in 4 (1.7%) in later time. Altogether 196 (85.2%) patients obtained satisfactory therapeutic effects, but 34 (14.8%) obtained unsatisfactory therapeutic effects. CONCLUSION: Small-segment allogeneic bones have good histocompatibility and osteogenesis, and they are good bone grafts in the bone transplantation.
