微创经皮骨穿刺注射自体红骨髓组织工程复合物治疗骨囊肿临床应.docVIP

微创经皮骨穿刺注射自体红骨髓组织工程复合物治疗骨囊肿临床应 　 作者：杨新明 石蔚 曾春萍 邹宇纬 孟宪勇 平立涛 李金 苏立军 杨峰 【摘要】 目的：探讨微创经皮骨穿刺注射自体红骨髓组织工程复合物治疗骨囊肿的临床疗效。方法：2004.1～2005.2月,对18例骨囊肿患者（男12例，女6例,平均年龄13岁；其中肱骨近端9例,股骨近端4例, 胫骨近端1例、远端1例,尺骨近端1、远端1例，桡骨远端1例）以玻璃酸钠为载体抽取自体红骨髓加入甲基强的松龙，在X线透视下,将2根骨穿针经皮分别自囊腔顶部和底部刺入骨囊肿内,抽去囊液,冲洗囊腔后注入复合物。其中14例注射1次,4例注射2次间隔2～3个月。结果：本组病例随访时间10～18月,平均14个月，骨愈合良好,无复发及并发症。根据Neer和Chrigira的X线评价骨囊肿愈合标准进行评估,本组18例治疗10个月后均达到Ⅳ级,骨囊腔完全愈合，愈合时间3～10个月,平均5个月，治愈率100%。结论：本方法治疗骨囊肿疗效确切、方法简单、不需手术、创伤小、痛苦轻、无并发症、费用较低、患儿及家长易于接受，是一种安全有效、治愈率高、便于基层医院推广使用的新型治疗方法。 【关键词】 骨囊肿；微创；自体红骨髓；移植；类固醇；甲基强的松龙；玻璃酸钠；组织工程 【ABSTRACT】 Objective:To investigate the clinical effectiveness of tissue engineering complexation of autologous red bone marrow and methylprednisolone with sodium hyaluronate injected percutaneously in the treatment of bone cysts.Methods:The treatment of 18 cases with bone cysts was reviewed,which there were treated from January 2004 to February 2005. There were12 males and 6 females with an average age of 13 yearsold. The bone cysts were located in the proximal humerus（n=9）,proximal femur（n=4）,proximal tibia（n=1）,distal tibia（n=1）,proximal ulna（n=1）,distal ulna（n=1）,and distal radius（n=1）.Under fluoroscopy, two fine bone marrow biopsy needls pierced the bone cysts from the top and the bottom of the cyst respectively.The intracystic fluid was drawn out,the cyst cavity was irrigated and then the tissue engineering complexation of autologous red bone marrow and methylprednisolone with sodium hyaluronate was injected in percutaneously.Among the 18cases,14 received 1 injection, 4 received 2 injections in 2 ～ 3 months interval.Results:The patients were followedup for 14 average months（10～18 months）.All 18 cysts were cured satisfactorily and no complication or recurrence occurred during the treatment .According to Neer and the Chrigira classification standards on the new bone formation, all 18 cases were classified as grade Ⅳ. The time for bone cysts cavity to grew together again in 18 cases was 3～10 months（mean time 5 months）. C