CAJ | 학술논문

背景：自体植骨是修复骨肿瘤刮除后骨缺损最理想的材料和方法，但存在增加手术创伤，取骨部位的后遗症如感染和疼痛及自体骨的取量有限等缺点。目的：分析硫酸钙人工骨和异种骨修复良性骨肿瘤刮除后骨缺损的临床疗效。方法：选择26例良性骨肿瘤患者，其中骨巨细胞瘤8例，内生软骨瘤5例，纤维组织细胞瘤4例，骨纤维异样增殖症3例，非骨化性纤维瘤2例，骨囊肿2例，动脉瘤样骨囊肿和软骨母细胞瘤各1例。12例采用单一硫酸钙骨粒填充肿瘤切除后的骨缺损，6例采用单一异种骨条填充肿瘤切除后的骨缺损，8例采用硫酸钙骨粒+异种骨条填充肿瘤切除后的骨缺损。治疗后1周内、3个月、1年拍X射线片检查，了解植骨愈合情况。结果与结论：治疗后随访36-72个月，发现硫酸钙骨粒的降解发生较早，一般治疗后1个月就开始出现骨粒降解，3个月大部分已降解完毕并有骨替代发生，1年骨修复塑型良好；异种骨条3个月后降解并有骨替代发生，植骨充填物边缘模糊，6个月后骨缺损及充填物之间边界变模糊，有融合现象，1年骨缺损内密度均匀，骨小梁形成明显，骨修复良好；骨粒+骨条混合植骨者介于单纯硫酸钙骨粒和单纯异种骨条之间，出现骨粒部分先降解先修复、骨条部分后降解后修复，一般术后1年达到骨性愈合。说明硫酸钙人工骨和异种骨在骨肿瘤性骨缺损修复应用中的效果良好，在良性骨肿瘤刮除后植骨可以替代自体骨植骨。
배경：자체식골시수복골종류괄제후골결손최이상적재료화방법，단존재증가수술창상，취골부위적후유증여감염화동통급자체골적취량유한등결점。목적：분석류산개인공골화이충골수복량성골종류괄제후골결손적림상료효。방법：선택26례량성골종류환자，기중골거세포류8례，내생연골류5례，섬유조직세포류4례，골섬유이양증식증3례，비골화성섬유류2례，골낭종2례，동맥류양골낭종화연골모세포류각1례。12례채용단일류산개골립전충종류절제후적골결손，6례채용단일이충골조전충종류절제후적골결손，8례채용류산개골립+이충골조전충종류절제후적골결손。치료후1주내、3개월、1년박X사선편검사，료해식골유합정황。결과여결론：치료후수방36-72개월，발현류산개골립적강해발생교조，일반치료후1개월취개시출현골립강해，3개월대부분이강해완필병유골체대발생，1년골수복소형량호；이충골조3개월후강해병유골체대발생，식골충전물변연모호，6개월후골결손급충전물지간변계변모호，유융합현상，1년골결손내밀도균균，골소량형성명현，골수복량호；골립+골조혼합식골자개우단순류산개골립화단순이충골조지간，출현골립부분선강해선수복、골조부분후강해후수복，일반술후1년체도골성유합。설명류산개인공골화이충골재골종류성골결손수복응용중적효과량호，재량성골종류괄제후식골가이체대자체골식골。
BACKGROUND:Autologous bone graft is the best method to repair bone defects after tumor curettage, but its shortcomings are as folows: increased surgical trauma, sequelae at bone graft site such as infection and pain, and a limited amount of autologous bone. OBJECTIVE:To analyze the effectiveness of xenograft and calcium sulphate artificial bone in treating bone defects after benign bone tumor removed. METHODS:Totaly 26 cases of benign bone tumor were selected, including 8 cases of giant celltumor, 5 of enchondroma, 4 of fibrous histiocytoma, 3 of bone fibrous dysplasia, 2 of non-ossifying fibroma, 2 cases of bone cysts, 1 of aneurysmal bone cyst and 1 of aneurysmal bone cyst and 1 case of chondroblastoma. Of the 26 cases, 12 cases underwent calcium sulphate pelets alone to fil bone defects after benign bone tumor removed, 6 cases were subjected to xenograft alone, and 8 cases were treated with calcium sulphate pelets combined with xenograft. The X-rays were taken at 1 week, 3 months, and 1 year after the operation in al patients to assess the bone healing process. RESULTS AND CONCLUSION:Al the patients were folowed up for 36-72 months. The absorption of calcium sulphate appeared to be absorbed earlier, the earlier absorption appearance could be observed as earlier as 1 month after the implantation, and most calcium sulphate was absolved and replaced by new bone at 3 months after the operation. The xenograft bone was degraded at 3 months post implantation and new bone formed. Osseo integration of the graft was observed at the periphery of the implant at 6 months post implantation. One year post implantation, trabecular bone was observed at the site with uniform bone density. In the combined group, thecalcium sulphate pelets were absorbed earlier and new bone formed earlier than the calcium sulphate alone group, and the xenograft absorbed later than the calcium sulphate pelets. Generaly, bony union was detectable 1 year after operation. These findings indicate that xenograft and calcium sulphate in treating benign bone tumor have acquired good results, which can be used as a substitute of autologous bone.