中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (5): 831-834.doi: 10.3969/j.issn.1673-8225.2012.05.017

• 细胞与组织移植 cell and tissue transplantation • 上一篇    下一篇

大块异体骨联合自体骨髓移植修复股骨上段肿瘤切除后缺损★

李  波1,2,陈  静3,阙祥勇1,陈文瑶1,李新志1   

  1. 1三峡大学仁和医院骨科,湖北省宜昌市  443001;  2宜昌长航医院骨外科,湖北省宜昌市  443003;3三峡大学医学院形态学部,湖北省宜昌市  443002
  • 收稿日期:2011-11-17 修回日期:2011-12-08 出版日期:2012-01-29
  • 通讯作者: 李新志,博士,副教授,副主任医师,硕士生导师,三峡大学仁和医院骨科,湖北省宜昌市 443001 lixpj@163.com
  • 作者简介:李波★,男,1977年生,硕士,主治医师,主要从事骨肿瘤和脊柱方面的研究。libo1019@126.com

Massive bone allograft combined with autologous bone marrow transplantation for proximal femoral defects resulting from tumor resection 

Li Bo1, 2, Chen Jing3, Que Xiang-yong1, Chen Wen-yao1, Li Xin-zhi1   

  1. 1Department of Orthopedics, Renhe Hospital of Three Gorges University, Yichang  443001, Hubei Province, China; 2Department of Orthopedics, Changhang Hospital of Yichang, Yichang 443003, Hubei Province, China; 3Department of Morphology, Medical College of Three Gorges University, Yichang  443002, Hubei Province, China
  • Received:2011-11-17 Revised:2011-12-08 Online:2012-01-29
  • Contact: Li Xin-zhi, Doctor, Associate professor, Associate chief physician, Master’s supervisor, Department of Orthopedics, Renhe Hospital of Three Gorges University, Yichang 443001, Hubei Province, China lixpj@163.com
  • About author:Li Bo★, Master, Attending physician, Department of Orthopedics, Renhe Hospital of Three Gorges University, Yichang 443001, Hubei Province, China; Department of Orthopedics, Changhang Hospital of Yichang, Yichang 443003, Hubei Province, China libo1019@126.com

摘要:

背景:由于骨肿瘤切除造成的骨组织缺损是临床面临的难题之一,而如何修复缺损是骨科领域的热点问题。
目的:探讨采用大块异体骨联合自体骨髓移植治疗股骨上段肿瘤的临床应用及疗效。
方法:于2000-07/2005-06采用辐照冻存的大块异体骨联合自体骨髓移植治疗股骨上段良性肿瘤切除后遗留大块骨缺损12例,手术采用类似脊柱的“蛋壳”技术,掏空股骨头,保留股骨头圆韧带及头的皮质骨,尽量保留股骨头的1/3的血供,应用大块异体骨联合自体骨髓移植加内固定治疗。
结果与结论:患者术后随访6~11年。术后所有12例患者的大块异体骨联合自体骨髓在X射线中均显示整合血管化良好,骨小梁通过自体骨。MSTS93总体平均评分为26.33分,患者肢体功能总的优良率为83.3%。提示大块异体骨联合自体骨髓移植是修复股骨上段肿瘤切除后骨大块缺损的有效方法,并能充分整合成周围的自体骨。

关键词: 骨肿瘤, 同种异体, 骨移植, 骨缺损, 骨髓移植

Abstract:

BACKGROUND: Bone defects due to bone tumor resection are difficult problems in clinic, and how to repair bone defects is a hotspot in the orthopedics.
OBJECTIVE: To discuss the clinical application and effect of massive bone allograft combined with autologous bone marrow transplantation for the defects after proximal femoral tumor resection. 
METHODS: From July 2000 to June 2005, a total of 12 patients with massive bone defects after proximal femoral tumor resections received irradiated frozen massive bone allograft combined with autologous bone marrow transplantation. The surgery used “eggshell” technology similar to the spinal cord, femoral head was empty, the round ligament and cortical bone of the femoral head was kept, as well as one third blood supply of the femoral head. Massive bone allograft combined with autologous bone marrow transplantation and internal fixation was performed.
RESULTS AND CONCLUSION: Patients were followed-up regularly for 6-11 years after operation. The X-ray film showed that vascularization and bone trabeculae crossing the host bone could be seen in 12 cases. In addition, the mean MSTS93 score of 12 patients was 26.33, and the excellent rate of limb function was 83.3%. Massive bone allograft combined with autologous bone marrow transplantation is an effective method for proximal femoral defects resulting from tumor resection and can integrate with the surrounding host bone.

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