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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。
BACKGROUND: Bone tumors and tumor-like lesions after bone scraping bone defects taken from the body bone filling, the amount of material can not fully meet the clinical needs, and for the bone area often left with varying degrees of complications, so that its clinical application has been significantly limited. Allogeneic bone with its structural and biological characteristics and autologous bone similar to rich sources, can be long-term preservation and ease of use and other characteristics of the increasingly widely used in clinical. OBJECTIVE: To observe the biocompatibility and clinical effect of allogeneic bone for filling and repairing benign bone tumors and tumor-like lesions after bone incision and curettage. Design: Retrospective analysis. SETTING: Department of Orthopedics, Second Affiliated Hospital of Inner Mongolia Medical College, pelvic surgery. PARTICIPANTS: Bone defects were repaired in all patients with bone tumor at the Department of Bone Oncology, the Second Affiliated Hospital of Inner Mongolia Medical College from December 1999 to December 2005 for the curettage of benign bone tumors and tumor-like lesions. Of 230 patients, 156 males and 74 females; aged 5 to 56 years. The patient agreed to use allogeneic bone and sign an allogenic bone protocol. The experiment was approved by the hospital ethics committee. Methods: ① The bone defect was repaired by allogeneic bone augmentation provided by Shanxi AoRui Biomaterial Co., Ltd / Shanxi Medical Bank. Benign bone tumors and bone cysts and fibrous dysplasia, such as intracapsular curettage, with allograft bone filling cavity. ② According to Mankin and other grading standards on the same bone graft assessment of efficacy, divided into two levels of satisfaction and dissatisfaction. X-ray films were taken on the operation site at 3, 6 and 12 months after operation, and were followed up for an average of 38 months to observe the curative effect. MAIN OUTCOME MEASURES: TISSUE COMPATIBILITY OF BONE TISSUE BONE DEFECT WITH ALLOGENIC BONE FILLER. Results: 230 patients all entered the main result analysis. ① allograft biocompatibility: a small number of patients with mild rejection after surgery. The implanted material has good biocompatibility and can be directly fused with the bone tissue of the patient at the implantation site without preventing the normal activity of the osteocytes on the surface or interfering with the natural replacement process of the autologous bone cells, ie, no immune rejection or very small . All cases achieved bony union 6 to 18 months after operation, with an average of 6.5 months. Complications: 34 cases of incision effusion light yellow liquid, of which 30 cases of wound healing after 2 weeks (14.8%); incision delayed healing in 4 cases (1.7%). ② Efficacy: satisfaction 196 cases (85.2%), not satisfied 34 cases (14.8%). Conclusion: Allograft bone has good histocompatibility and osteogenesis, which is a good bone graft material in bone transplantation.