纳米羟基磷灰石聚酰胺66修复肢体良性骨缺损的临床疗效分析.docVIP

纳米羟基磷灰石/聚酰胺66修复肢体良性骨缺损的临床疗效分析 张斌 段宏 杨红胜 邹昌 李鸿 严永刚 屠重棋 作者单位610041 成都，四川大学华西医院骨科 通讯作者段宏 【摘要】目的 初步评估和分析纳米羟基磷灰石/聚酰胺66 (nano-hydroxyapatite polyamide 66，n-HA/PA66)修复良性骨肿瘤术后骨缺损的临床效果和安全性。方法 2007年11月至2010年12月，应用n-HA/PA66骨填充材料修复114例良性骨肿瘤术后骨缺损肿瘤刮除、灭活及人工骨植入70例，28例加用内固定，16例加用异体骨板和内同定。结果 除10例失随访外，104例获得随访，随访时间3~33个月，平均8.2个月。伤口均I/甲愈合，无一例发生切口感染、非特异炎症反应和排斥反应；术前、术后的血常规、免疫、肝、肾功能检查均无明显异常。X线和CT检查示：术后1个月，病灶区密度逐渐升高，可见植骨周围与自体骨结合处模糊，少量新生骨痂形成；术后3个月，病灶区从颗粒植骨周围间隙开始向中心融合成片，更多新生骨痂影融合；术后6个月，病灶区密度明显升高，病灶区大量新生骨痂形成。临床骨愈合时间为术后2~6个月，平均2.9个月，愈合率为95.3％。结论 n-HA/PA66骨填充材料的生物相容性良好，无明显排斥反应和非特异炎症反应，修复囊性良性骨肿瘤和瘤样病变效果良好。 【关键词】羟基磷灰石类；酰胺类；骨代用品；骨肿瘤；骨疾病 n-HA／PA66 in repairing bone defect due to benign bone tumors ZHANG Bin, DUAN Hong, YANG Hongsheng, et al. Department of Orthopaedics, West China Hospital, Sichuan University, Chendu,610041,PRC 【Abstract】 Objective To evaluate the clinical effect and safety of nano-hydroxyapatite/polyamide66 (n-HA/PA66)in bone defects due to bone tumors． Methods From November 2007 to December 2010，114patients(70 males，44 females；age range：18~62 years，average 37 years ) with the bone defects due to benign bone tumors and lesion resection were treated with the n-HA/PA66．All benign bone tumors underwent the curettage，inactivation measures and then the tumor cavities were filled up with the artificial bone．Of all the patients，28 benign bone tumors also placed internal fixation，and 16 placed both variant bone plates and internal fixation． Results 10 patients lost to follow, Others were evaluated at a mean follow up of 8.2 months(range：3~30 months)．All the incisions healed by the first intention．None developed infection，non-specific inflammatory reaction and rejection reaction．Both preoperative and postoperative results of the full set of immunization had no significant abnormalities．All patients had no obvious liver and kidney functional lesion．X-ray and CT showed that at 1 month after operation，the density of the focal zone increased gradually．The junction of bone graft and autogenous