刘鹏　马敏杰　杨小彬

[摘 要] 目的：分析人工骨混合自体骨用于骨肿瘤骨切除后填充的临床效果，探讨其临床应用价值。方法：以我院收治的65例接受骨切除的骨肿瘤患者为研究对象，按照患者填充方式，将接受人工骨混合自体骨填充的患者纳入观察组（n=29），将接受自体骨填充的患者纳入对照组（n=36），比较两组患者植骨量、愈合情况、骨材料降解率，比较其临床效果及安全性。结果：观察组与对照组平均植骨量为（9.9±1.6）mLVS（7.6±1.8）mL，观察组植骨量稍高于对照组，但组间比较差异无统计学意义（P>0.05）；观察组平均愈合时间为（8.9±1.5）个月，对照组平均愈合时间为（8.7±1.6）个月，两组患者植骨愈合时间、愈合情况、骨材料降解率比较，差异无统计学意义（P>0.05）；术后均未见伤口感染、不愈合、排异反应等并发症发生；观察组末次随访MSTS评分为（28.71±6.26）分，对照组末次随访MSTS评分为（28.50±6.33）分，组间差异无统计学意义（P>0.05）。结论：人工骨混合自体骨能够有效填充骨肿瘤骨切除后缺损区域，该方案能够在减少自体骨移植量的基础上保证良好的填充效果及安全性。

[关键词] 人工骨；自体骨；骨肿瘤；骨切除；填充

中图分类号：R738.1 文献标识码：B 文章编号：2095-5200（2016）05-033-04

DOI：10.11876/mimt201605013

[Abstract] Objective： To analyze the clinical effect of artificial bone mixed with autologous bone for filling after bone tumor resection and to explore its clinical application value. Methods： 65 cases of patients with bone tumor resection admitted in our hospital were selected as the research object， according to bone-filling methods， patients who received artificial bone mixed with autologous bone filling method were included into the observation group （n=29）， the patients who received autologous bone graft were included into the control group （n=36）， compared bone graft mass， bone healing and bone repair material degradation rate between the two groups of patients， and compared their clinical efficacy and safety. Results： The average bone graft mass of the observation group and the control group was （9.9±1.6） mL vs （7.6±1.8） mL， respectively， bone graft mass of the observation group is slightly higher than that of the control group， but there was no significant difference between the two groups （P>0.05）； the average bone healing time of observation group was （8.9±1.5） months， that of control group time was （8.7±1.6） months， bone healing time， healing situation， bone material degradation rate were compared between two groups of patients， the difference was not statistically significant （P>0.05）； there were no postoperative wound infection， nonunion， rejection and other complications in both groups； The Musculoskeletal Tumor Society （MSTS） score of the observation group at the end of the follow-up was （28.71±6.26） points， and that of the control group was （28.50±6.33） points， there was no significant difference between the two groups （P>0.05）. Conclusions： Artificial bone mixed with autologous bone can effectively fill the bone defect area after bone tumor resection， which can reduce the autologous bone graft mass and ensure good filling effect and safety.

[Key words] artificial bone； autogenous bone； bone tumor； bone resection； filling

骨肿瘤好发于股骨、胫骨、肱骨及桡骨等四肢部位，上述骨骼均扮演重要负重或持重角色，因此，骨肿瘤刮除后骨缺损的有效填充是恢复四肢骨坚固稳定、保证患肢功能的关键[1]。理想的植骨材料应具有生物相容性及强度稳定、骨形成能力佳、抗原性小、骨诱导和骨传导特性良好等特点，就此标准而言，自体骨移植方为骨科移植的“金标准”[2]。虽然自体骨具……