吻合血管的腓骨自体骨髓复合移植治疗大块骨缺损.pdfVIP

单纯自体吻合血管腓骨移植组：术后行移植腓骨动脉造影及彩超检查腓动脉血流，均 显示腓动脉血流通畅。平均随访时间96w(85w—112w)，移植腓骨愈合时间平均 14w(12w——18w)，移植腓骨愈合时形态增粗率22% （20%—26% ），平均随访时间 移植腓骨形态增粗率平均140% （100%——170%）。 对两组数据进行统计学分析，采用SPSS10.0成组设计两样本均数t检验，检验水 准：a=0.05,t=3.581,p0.05,可认为自体吻合血管的腓骨一自体骨髓复合移植较单纯自 体吻合血管腓骨移植组愈合时间明显缩短；比较平均随访时间内移植腓骨形态增粗 率，t=2.984 ，p0.05 ，可认为吻合血管的腓骨一自体骨髓复合移植较单纯自体吻合血 管腓骨移植组在同一时间段内形态增粗率明显增加。 结论:与单纯吻合血管的腓骨移植相比，自体骨髓和吻合血管的腓骨复合移植后， 移植腓骨形态增粗率的时间更早，增粗速度更快。 关键词 腓骨；自体骨髓；复合移植；大块骨缺损；形态改变；显微外科 Treatment of segmental Defects of the Tibia Using the Vascularized Fibula Combined with Autologous Bone-marrow Speciality: Traditional Chinese orthopedic and Traumatology Author: Lv Hao Tutor: Professor Xu Zhan-wang Abstract Objective ：To explore the influence of autologous bone-marrow on morphological change of the vadcularized fibular graft and to find a relative ideal method for treatment of mass bone deficits of the tibia .Skeletal trauma, osteotumor, osteomyelitis, and congenital pseudarthrosis. To explore the best way of reserving for limbs with normal function extremely. Method：the fifty-nine patients with mass bone deficits in the tibia were treated with autologous bone_marrow combined with vascularizd fibular graft.Fifreen cases were involved as traumatic ostenomyelitis or osteomylitic seqesetration due to congenital pseudarthrosis.The eight cases were diagnosed as ostea-tumor and congenital pesudarthrosis.The eigt cases were diagnosed as osteo-tumor and congenital pseudarthrosis.The twenty-three patients were randomly divided into two groups,group A:autologous bone-marrow combined with vascularized fibula graft,and group B:simple vascularized fibula graft. 1.surgical technique:Sequestruum with granulation and unsoud