首页|人工骨浆联合同种异体骨治疗四肢骨折骨缺损的应用

人工骨浆联合同种异体骨治疗四肢骨折骨缺损的应用

Application of artificial bone pulp combined with allogeneic bone in the treatment of bone defect of limbs fracture

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目的 探究人工骨浆联合同种异体骨治疗四肢骨折骨缺损的应用价值.方法 选取2021年8月至2022年8月于赣南医学院第二附属医院接受手术的160例四肢骨折骨缺损患者作为研究对象,采用随机数字表法将其分为对照组、人工骨浆组、异体骨组和联合治疗组,每组各40例.对照组患者采取自体松质骨填充于骨缺损部位;异体骨组患者取骨组织库中提供的同种异体骨在骨缺损处填实;人工骨浆组使用人工骨浆,手动塑形后挤压到骨空隙处进行填充,联合治疗组联合骨浆和同种异体骨在骨缺损位置进行填充.比较四组患者的围手术期指标、影像学情况、功能评分及并发症发生情况.结果 联合治疗组的术中出血量、术后引流量、手术费用均少于其他三组,且手术时间、住院时间均短于其他三组,差异有统计学意义(P<0.05);联合治疗组的生活质量健康调查简表(SF-36)评分、诺丁汉健康量表(NHP)评分、视觉模拟评分法(VAS)满意度评分均高于其他三组,且VAS疼痛评分均低于其他三组,差异有统计学意义(P<0.05);影像学情况显示,联合治疗组患者6个月后X线示植骨处均有骨痂生长,且1年骨性愈合率均高于其他三组,差异有统计学意义(P<0.008);联合治疗组的并发症总发生率低于其他三组,差异有统计学意义(P<0.008).结论 针对四肢骨折骨缺损患者,采取人工骨浆联合同种异体骨治疗有助于改善患者围手术期指标、促进骨愈合速度,同时降低并发症发生率并提高生活质量,且总体治疗的安全性更高.
Objective To explore the application value of artificial bone pulp combined with allogeneic bone in the treat-ment of bone defect of limbs fracture.Methods A total of 160 patients with limb fracture and bone defect who received surgery in the Second Affiliated Hospital of Gannan Medical College from August 2021 to August 2022 were selected as the study objects.By using random number table method,they were divided into control group,artificial bone pulp group,allo-geneic bone group and combined treatment group,with 40 cases in each group.In control group,autogenous cancellous bone was used to fill the bone defect.Allogeneic bone provided in the bone tissue bank of patients in the allogeneic bone group was filled at the bone defect.In the artificial bone pulp group,the artificial bone pulp was manually shaped and squeezed into the bone space for filling.In the combined treatment group,the bone pulp and allogeneic bone were combined to fill the bone defect site.The perioperative indexes,imaging status,functional scores and complications of the four groups were com-pared.Results The intraoperative blood loss,postoperative drainage volume and surgical cost of the combined treatment group were all lower than those of the other three groups,and the operation time and hospital stay were shorter than those of the other three groups,with statistical significance(P<0.05).The quality of life health survey short form 36(SF-36)scores,Nottingham health scale(NHP)scores and visual analogue scale(VAS)satisfaction scores of the combined treatment group were higher than those of the other three groups,and the VAS pain scores were lower than those of the other three groups,with statistical significances(P<0.05).The imaging results showed that all patients in the combined treatment group had callus growth at the bone graft sites by X-ray after 6 months,and the 1-year bone healing rate was higher than that in the other three groups,the difference was statisti-cally significant(P<0.008).The total complication rate of the combined treatment group was lower than that of the other three groups,and the difference was statistically significant(P<0.008).Conclusion For patients with limb fracture and bone defect,artificial bone pulp combined with allogeneic bone therapy can improve perioperative indexes,promote bone healing speed,reduce the incidence of complications and improve quality of life,and the overall treatment safety is higher.

Artificial bone pulpAllogeneic boneLimb fracture bone defectPerioperative indicatorsImaging statusFunctional scoreSafety

陈吉冰、顾卢妹、肖曜升

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赣南医学院第二附属医院骨科,江西赣州 341600

人工骨浆 同种异体骨 四肢骨折骨缺损 围手术期指标 影像学情况 功能评分 安全性

2024

中国当代医药
中国保健协会 当代创新(北京)医药科学研究院

中国当代医药

影响因子:1.215
ISSN:1674-4721
年,卷(期):2024.31(14)