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目的比较人工骨(羟基磷灰石+β-磷酸三钙)与同种异体松质骨在良性骨肿瘤刮除后骨缺损重建中的临床应用效果。方法研究自2009年1月至2009年12月在我院接受人工骨与同种异体松质骨植骨的两组病例。两组病例在治疗时间、年龄、性别、病种、病灶部位、植骨量和随访时间等方面均匹配良好。通过随访影像学和临床情况,比较两组病例植骨术后的愈合速度和愈合率,分析人工骨愈合的影响因素。结果人工骨与同种异体骨的初步愈合率分别为100%和87.5%(P=0.246);人工骨与同种异体骨的平均愈合时间分别为9.1个月(3-12个月)和11.2个月(6-15个月)(P=0.718)。回归分析显示患者性别(P=0.592)、年龄(P=0.754)、病灶部位(P=0.671)、病种(P=0.250)和植骨量(P=0.798)均不是影响人工骨愈合的显著因素。人工骨组与同种异体骨组患者术后MSTS评分分别为平均28.5分(21～30分)和平均28.7分(26～30分)(P=0.869)。人工骨植入术后未见伤口感染、不愈合、排异反应等并发症。结论羟基磷灰石+β-磷酸三钙材质人工骨用于肢体良性骨肿瘤刮除后骨缺损的重建,愈合效果良好,术后未见不良反应,可使患者临床获益。
Objective To compare the clinical effects of artificial bone (hydroxyapatite + β-tricalcium phosphate) and allogenic cancellous bone in reconstructing bone defects after the curettage of benign bone tumors. Methods From January 2009 to December 2009 in our hospital to accept artificial bone and allograft cancellous bone graft in two groups of cases. The two groups of patients in the treatment time, age, gender, disease, lesion site, bone mass and follow-up time and so on are good. Through follow-up imaging and clinical conditions, the healing rate and healing rate of the two groups were compared, and the influencing factors of artificial bone healing were analyzed. Results The initial healing rates of artificial bone and allograft were 100% and 87.5%, respectively (P = 0.246). The average healing time of artificial bone and allograft was 9.1 months (3-12 months) and 11.2 Months (6-15 months) (P = 0.718). The regression analysis showed that neither the gender (P = 0.592), age (P = 0.754), lesion site (P = 0.671), disease type (P = 0.250) factor. The postoperative MSTS scores of the artificial bone group and the allograft group were 28.5 (21-30) and 28.7 (26-30), respectively (P = 0.869). There was no wound infection, non-union or rejection after artificial bone implantation. CONCLUSION: Hydroxyapatite + β-tricalcium phosphate artificial bone is used to reconstruct bone defects after the curettage of benign bone tumors in limbs. The healing effect is good and no adverse reactions are found after operation.