同种异体骨及自体骨移植治疗青少年脊柱侧凸比较探究.docVIP

同种异体骨及自体骨移植治疗青少年脊柱侧凸比较探究 　【摘要】 观察同种异体骨移植与自体骨移植治疗青少年脊柱侧凸的临床效果。［方法］对1996~2006年本科收治的63例青少年脊柱侧凸患者的临床资料，采用回顾性“病例-对照”研究方法进行分析，A组（同种异体骨移植组）32例，10~15岁，平均12.2岁；Cobbs角38°~113°，平均62°；B组（自体髂骨移植组）31例，年龄9~14岁，平均12.4岁；Cobbs角41°~105°，平均54°。所有患者均选择中华长城椎弓根内固定系统经后路矫正，术后定期随访并对临床效果进行评估。［结果］出院后2个月即开始随访，随访时间18~24个月，平均26个月；亦无严重并发症发生；A组的手术时间、失血量较B组患者减少，组间具有统计学意义（P＜0.01)。［结论］两组患者具有相似的临床效果，在严格掌握适应证，充分术前准备、正确手术操作、及时术后处理的前提下，同种异体骨移植能够有效替代自体髂骨移植治疗青少年脊柱侧凸。 【关键词】 脊柱侧凸 脊柱融合术 骨移植 异体骨 Abstract：［Objective］To compare the clinical results between allograft and autograft for treatment of scoliosis in the adolescent.［Method］A retrospective study was made in 63 cases of adolescent patients with scoliosis who were operated on with posterior instrumentation from 1996~2006.These patients were divided into two groups.In group A,32 patients aged 10 to 15 years with an average of 12.2 years,had a mean Cobbs angle of 62°(ranged,38° to 113°),were received allograft bone grafting.The patients were followed up for at least 18 months with an average of 26 months.Clinical and radiographic evaluations were performed.［Results］Operating time and blood loss in group A were less than that in group B (P＜0.01).Solid bony fusion was achieved in all patients.The fusion rate and the loss of correction had no significant difference between the group A and the group B.［Conclusion］With proper indication,allograft could be a good alternative to autologous iliac bone for its safety,efficacy and reliability. Key words:scoliosis; spinal fusion; bone transplantation; allograft 确切地植骨融合是青少年脊柱侧凸手术成功的关键之一。理论上讲，自体骨是最理想的植骨来源〔1〕，但因其来源以及术后并发症等问题，限制了其应用〔2〕。相对而言，同种异体骨移植来源广泛，制备简单，已越来越广泛地被应用于临床。本科自1996~2006年收治青少年脊柱侧凸患者63例，根据移植骨术式的不同分组为A、B两组：A组接受同种异体骨移植术，共32例；B组接受自体骨移植术，共31例。经“病例-对照”研究证实，同种异体骨移植效果好于自体骨移植。现报告如下。 1 临床资料 1.1 一般资料 A组：32例，男22例，女10例；年龄10~15岁，平均12.2岁；特发性脊柱侧凸28例，先天性脊柱侧凸4例；Cobbs角38°~113°，平均62°。B组：31例，男22例，女11例；年龄9~14岁，平均12.4岁；特发性脊柱侧凸25例，先天性脊柱侧凸6例；Cobbs角41°~105°，平均54°。两组在性别、年龄、身高、体重、侧凸类型及角度等方面无统计学差异。 1.2 治疗方法 1.2.1 同种异体骨制备 同种异