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《同種異體骨植骨聯(lián)合鎖定加壓鋼板治療四肢良性骨腫瘤及類瘤病變的隨訪研究》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、同種異體骨植骨聯(lián)合鎖定加壓鋼板治療四肢良性骨腫瘤及類瘤病變的隨訪研究張澤華,張帥,羅飛,王嘉嘉,謝肇,馬樹(shù)枝,許建中,王序全(400038重慶,第三軍醫(yī)大學(xué)西南醫(yī)院骨科)[摘要]目的探討同種異體骨植骨聯(lián)合鎖定加壓鋼板治療四肢良性骨腫瘤的臨床療效和安全性。方法總結(jié)2005年3月至2011年3月我科收治的56例接受同種異體骨植骨聯(lián)合鎖定加壓鋼板手術(shù)治療的四肢良性骨腫瘤患者病例。其中男31例,女25例,年齡10~61歲,平均38.7±3.6歲;疾病類型:?jiǎn)渭児悄夷[16例,骨纖維結(jié)構(gòu)不良15例,動(dòng)脈瘤樣骨囊腫10例,骨巨細(xì)胞瘤9例,骨母細(xì)胞瘤3例,嗜酸性肉芽腫3例
2、,其中合并病理性骨折36例,均行病灶刮除、同種異體骨植骨、鎖定加壓鋼板內(nèi)固定治療,觀察植骨量、有無(wú)免疫排斥反應(yīng)、植骨愈合情況、愈合時(shí)間、病灶有無(wú)復(fù)發(fā)等。結(jié)果本組病例植骨量為(23.5±10.3)g,隨訪時(shí)間(25.5±12.3)(12~60)個(gè)月,5人失訪。2例骨巨細(xì)胞瘤復(fù)發(fā),余49例均獲治愈,4例出現(xiàn)排異反應(yīng),平均骨愈合時(shí)間為6月,術(shù)后1年根據(jù)骨骼愈合情況取出內(nèi)固定,未出現(xiàn)骨不連及再骨折情況。結(jié)論同種異體骨促進(jìn)成骨、修復(fù)骨缺損效果確切,排異反應(yīng)發(fā)生率低,在徹底刮除病變的前提下,與鎖定加壓鋼板聯(lián)合應(yīng)用可有效治療四肢長(zhǎng)骨良性骨腫瘤及類瘤病變。[關(guān)鍵詞]同種異
3、體骨;鎖定加壓鋼板;良性骨腫瘤;類瘤病變TreatmentofBenignBoneTumorsandTumor-likeLesionsinExtremitiesUsingAllograftBoneandLockedCompressionPlateZhangZehua,ZhangShuai,LuoFei,WangJiajia,XieZhao,MaShuzhi,XuJianzhong,WangXuquan(DepartmentofOrthopaedics,SouthwestHospital,TheThirdMilitaryMedicalUniversity,C
4、hongQing,China,400038)[Abstract]ObjectiveTodeterminetheclinicalefficacyandsaftyofallograftboneandlockingcompressionplateinthetreatmentofbenignbonetumorsandtumor-likelesionsinextremities.MethodsBetweenMar2005andMar2011,56patientsinourunitunderwentradicalcurettage,allograftbonetrans
5、plantationandlockedcompressionplatefixationforbenignbonetumorsandumor-likelesionswerereviewed,therewere31maleand25femalepatientswithameanageof38.7±3.6years(range10to61years).Thetypesofprimarytumorinthesepatientswere:16patientswithbonecyst,15patientswithbonefibrousdysplasis,10patie
6、ntswithaneurysmalbonecyst,9patientswithbonegiantcelltumor,3patientswithosteoblastoma,3witheosinophilicgranulomatosis.Pathologicalfractureoccurredin36patients.Thevolumeofallograftbone,immunologicalrejection,bonereconstruction,tumorrecurrencewereconcerned.ResultsThemedianbonemasswer
7、e23.5±10.3g,themeanfollowupdurationwas25.5±12.3months(range,12-60month),5patientswerelostforfollowup.Nopatientshadincorrectreductionoffracture,looseningandruptureofinternalfixation,4patientshadcomplicationsasimmunologicalrejection,2patientshadrecurrenceofbonegiantcelltumor.Themedi
8、anperiodsofbonehealingwere6months