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固骼生材料修复四肢骨折骨缺损：植骨融合效应杜思橦;杨京春【摘要】背景：新型骨修复材料固骼生具有独特的生物活性和良好的生物相容性，临床修复骨缺损可以发挥出良好的键合性，有效促进软组织及骨组织的键合。
<br> 目的：分析固骼生材料修复四肢骨折所致骨缺损的临床效果。
<br> 方法：纳入67例四肢骨折致骨缺损患者，其中男37例，女30例，年龄17-81岁，均实施固骼生材料修复治疗。
修复后3 d，检测血常规、心肾功能及血清学补体C3、补体C4、免疫球蛋白G、免疫球蛋白A、免疫球蛋白M等水平；修复后随访12个月，X射线观察植骨融合效果。
<br> 结果与结论：所有患者切口均一期愈合，未出现切口感染病例，各项实验室指标未见明显异常，未发生任何排斥和非特异炎症反应，植骨区未出现不适感或者异常症状；随访12个月，所有患者骨折均呈骨性愈合，植骨不融合1例，可能不融合1例，不确定融合2例，可能融合33例，坚强融合30例，植骨融合率为94%。
表明采用固骼生材料修复四肢骨折所致骨缺损具有良好的生物相容性，修复效果良好，植骨融合率高。
%BACKGROUND:As a new kind of bone repair material, NovaBone has a unique biological activity and good biocompatibility. It has a good binding role in the clinical repair of bone defects, so as to effectively promote the bonding of soft tissue and bone tissue. <br> OBJECTIVE: To explore the clinical effect of NovaBone in the repair of bone defects due to limb fractures. <br> METHODS: Sixty-seven patients with bone defectsdue to limb fractures were enroled, 37 males and 30 females, aged 17-81 years. Al the patients underwent NovaBone repair. Three days after repair, routine blood test, heart and kidney function, serum complement C3,complement C4, immunoglobulin G, immunoglobulin A, immunoglobulin M were detected; 12 months after repair, X-ray observation was performed for bone graft fusion effect. <br> RESULTS AND CONCLUSION:Al patients presented with stage I healing, and there was no incision infection, rejection or non-specific inflammation. Patients felt no discomfort or developed symptoms in the bone graft region. Laboratory indexes showed no abnormity. At 12 months after treatment, bony union was seen in al patients, and there was 1 case of nonunion, 1 case of possible nonunion, 2 cases of uncertain nonunion, 33 cases of possible union, 30 cases of strong union, with a bone fusion rate of 94%. These findings suggest that NovaBone materials for repair of bone defect due to limb fractures have good biocompatibility and obtain good clinical effect.【期刊名称】《中国组织工程研究》【年(卷),期】2015(000)038【总页数】5页(P6121-6125)【关键词】生物材料;骨生物材料;固骼生材料;四肢骨折;骨缺损;植骨融合【作者】杜思橦;杨京春【作者单位】北京积水潭医院特需一病房，北京市 100035;北京积水潭医院特需一病房，北京市 100035【正文语种】中文【中图分类】R318文章亮点：试验采用固骼生材料修复四肢骨折所致骨缺损，未发生炎症反应及肝肾损害等，说明固骼生是一种具有良好安全性的骨移植材料；随访X射线观察结果显示，在材料生物活性的影响下，达到了良好的骨缺损修复效果，植骨融合率高。
![人工骨(磷酸三钙生物陶瓷)介绍[业界研究]](https://img.taocdn.com/s1/m/e4db747b84254b35effd347a.png)
大范围骨缺损的修复治疗进展侯志峰【摘要】@@ 骨创伤、肿瘤、炎症等各种原因引起的大范围骨缺损是骨科临床的常见病和难治病,由于缺损的范围比较大,很容易引起功能障碍,降低患者的生活质量乃至引起病死.通常的治疗方法是进行骨移植修复.用来修复的材料要求很高,理想的骨修复材料要求同时具备骨传导、骨诱导和骨生成这三项功能.本文拟将修复治疗综述如下.【期刊名称】《实用医药杂志》【年(卷),期】2011(028)008【总页数】4页(P754-757)【关键词】骨缺损;治疗【作者】侯志峰【作者单位】266071,山东青岛,济南军区青岛第一疗养院三科【正文语种】中文【中图分类】R681骨创伤、肿瘤、炎症等各种原因引起的大范围骨缺损是骨科临床的常见病和难治病，由于缺损的范围比较大，很容易引起功能障碍，降低患者的生活质量乃至引起病死。
通常的治疗方法是进行骨移植修复。
用来修复的材料要求很高，理想的骨修复材料要求同时具备骨传导、骨诱导和骨生成这三项功能。
本文拟将修复治疗综述如下。
1 自体骨移植自1809年Merrem在动物颅骨上环钻后植入骨片并获得顺利愈合后这一方法在临床上得到了大范围的推广。
自体骨材料分为游离自体骨和带血管自体骨两种。
游离自体骨上的活细胞能够在移植后依赖于弥散而得以存活，后在移植局部形成新的骨组织，后通过爬行替代的作用缓慢修复骨缺损。
这种方法操作简单，但是由于恢复缓慢，只能用于极少量骨缺损的治疗；对于带血管的自体骨组织而言，由于血供比较丰富，不会发生骨坏死和骨吸收，不需要经过缓慢的爬行替代过程，能直接与受骨区域组织融合，因而修复过程速度快，具有愈合期短，固定时间短，有利于肢体功能恢复的优点。
但是由于带血管的骨组织起源及位置恒定，移植起来要求较高，在临床使用中相对受限。
总之，自体骨移植不会产生免疫排斥反应，能够最大限度的发挥骨生长因子的作用及保留存活的成骨细胞，成骨效果是最好的。
但是自体骨移植受困于取材有限，而且额外手术增加患者痛苦，扩大创伤，特别是对于重症者和年老体弱者，因此在临床上应用颇多限制。
骨移植的临床进展
阮亚;苏涛
【期刊名称】《人民军医》
【年(卷),期】1993()10
【摘要】1878年Macewen为一3岁小儿行3次异体骨移植治疗肱骨骨髓炎并首次获得成功,随后骨移植作为治疗骨不连、延迟连接、外伤、感染或肿瘤切除术后骨缺损而被广泛应用于临床。
骨移植按其来源分为四种:自体骨移植、同种异体骨移植、异种异体骨移植和人工骨移植。
现分别就其临床进展叙述如下。
一、自体骨移植(Autograft) 自体骨移植因其效果可靠,与受骨融合速度快,故常被用作衡量其他骨移植的标准。
骨移植的成骨作用主要依赖于爬行替代及骨诱导。
【总页数】3页(P34-36)
【关键词】骨骼移植术;临床;人工骨;自体骨
【作者】阮亚;苏涛
【作者单位】148医院外三科
【正文语种】中文
【中图分类】R687.34
【相关文献】
1.自体牙骨移植物临床应用进展 [J], SHEN Xu-liang;TAO De-tao
2.自体骨移植修复骨缺损的临床研究进展 [J], 杨思敏; 王新卫
3.自体牙本质作为骨移植材料的临床应用进展 [J], 肖闻澜; 胡琛; 荣圣安; 屈依丽
4.自体牙本质作为骨移植材料的临床应用进展 [J], 肖闻澜;胡琛;荣圣安;屈依丽
5.下颌升支区半柱状自体骨移植与颏部矩形自体骨移植在美学区水平向骨增量中的临床应用效果评价——随机对照临床实验 [J], 赵雪竹;唐志辉;邹立东;许卫华
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纳米人工骨混合自体骨用于骨肿瘤骨切除后填充效果刘鹏;马敏杰;杨小彬;李涛【摘要】Objective: To analyze the clinical effect of artiifcial bone mixed with autologous bone for iflling after bone tumor resection and to explore its clinical application value.Methods: 65 cases of patients with bone tumor resection admitted in our hospital were selected as the research object, according to bone-iflling methods, patients who received artiifcial bone mixed with autologous bone iflling method were included into the observation group (n=29), the patients who received autologous bone graft were included into the control group (n=36), compared bone graft mass, bone healing and bone repair material degradation rate between the two groups of patients, and compared their clinical efifcacy andsafety.Results: The average bone graft mass of the observation group and the control group was (9.9±1.6) mL vs (7.6±1.8) mL, respectively, bone graft mass of the observation group is slightly higher than that of the control group, but there was no signiifcant difference between the two groups (P>0.05); the average bone healing time of observation group was (8.9±1.5) months, that of control group time was (8.7±1.6) months, bone healing time, healing situation, bone material degradation rate were compared between two groups of patients, the difference was not statistically signiifcant (P>0.05); there were no postoperative wound infection, nonunion, rejection and other complications in both groups; The Musculoskeletal Tumor Society (MSTS) score of the observation group atthe end of the follow-up was (28.71±6.26) points, and that of the control group was (28.50±6.33) points, there was no signiifcant difference between the two groups (P>0.05).Conclusions:Artiifcial bone mixed with autologous bone can effectively ifll the bone defect area after bone tumor resection, which can reduce the autologous bone graft mass and ensure good iflling effect and safety.%目的：分析人工骨混合自体骨用于骨肿瘤骨切除后填充的临床效果，探讨其临床应用价值。
异种骨和人工骨修复骨肿瘤性骨缺损
方志伟，李舒，樊征夫，白楚杰，刘佳勇，薛瑞峰，张路
北京大学肿瘤医院暨北京市肿瘤防治研究所，骨与软组织肿瘤科，恶性肿瘤发病机制及转化研究教育部重点实验室，北京市 100142 Xenograft and calcium sulphate in treating benign bone tumor
Fang Zhi-wei, Li Shu, Fan Zheng-fu, Bai Chu-jie, Liu Jia-yong, Xue Rui-feng, Zhang Lu
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Orthopedic Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China
摘要
背景：自体植骨是修复骨肿瘤刮除后骨缺损最理想的材料和方法，但存在增加手术创伤，取骨部位的后遗症如感染和疼痛及自体骨的取量有限等缺点。
目的：分析硫酸钙人工骨和异种骨修复良性骨肿瘤刮除后骨缺损的临床疗效。
方法：选择26例良性骨肿瘤患者，其中骨巨细胞瘤8例，内生软骨瘤5例，纤维组织细胞瘤4例，骨纤维异样增殖症3例，非骨化性纤维瘤2例，骨囊肿2例，动脉瘤样骨囊肿和软骨母细胞瘤各1例。
12例采用单一硫酸钙骨粒填充肿瘤切除后的骨缺损，6例采用单一异种骨条填充肿瘤切除后的骨缺损，8例采用硫酸钙骨粒+异种骨条填充肿瘤切除后的骨缺损。
治疗后1周内、3个月、1年拍X射线片检查，了解植骨愈合情况。
结果与结论：治疗后随访36-72个月，发现硫酸钙骨粒的降解发生较早，一般治疗后1个月就开始出现骨粒降解，3个月大部分已降解完毕并有骨替代发生，1年骨修复塑型良好；异种骨条3个月后降解并有骨替代发生，植骨充填物边缘模糊，6个月后骨缺损及充填物之间边界变模糊，有融合现象，1年骨缺损内密度均匀，骨小梁形成明显，骨修复良好；骨粒+骨条混合植骨者介于单纯硫酸钙骨粒和单纯异种骨条之间，出现骨粒部分先降解先修复、骨条部分后降解后修复，一般术后1年达到骨性愈合。
说明硫酸钙人工骨和异种骨在骨肿瘤性骨缺损修复应用中的效果良好，在良性骨肿瘤刮除后植骨可以替代自体骨植骨。
中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程
全文链接：
关键词：生物材料；骨生物材料；骨肿瘤；人工骨；硫酸钙；异种骨；植骨；
Abstract：
BACKGROUND: Autologous bone graft is the best method to repair bone defects after tumor curettage, but its shortcomings are as follows: increased surgical trauma, sequelae at bone graft site such as infection and pain, and a limited amount of autologous bone.
OBJECTIVE: To analyze the effectiveness of xenograft and calcium sulphate artificial bone in treating bone defects after benign bone tumor removed.
METHODS: Totally 26 cases of benign bone tumor were selected, including 8 cases of giant cell tumor, 5 of enchondroma, 4 of fibrous histiocytoma, 3 of bone fibrous dysplasia, 2 of non-ossifying fibroma, 2 cases of bone cysts, 1 of aneurysmal bone cyst and 1 of aneurysmal bone cyst and 1 case of chondroblastoma. Of the 26 cases, 12 cases underwent calcium sulphate pellets alone to fill bone defects after benign bone tumor removed, 6 cases were subjected to xenograft alone, and 8 cases were treated with calcium sulphate pellets combined with xenograft. The X-rays were taken at 1 week, 3 months, and 1 year after the operation in all patients to assess the bone healing process.
RESULTS AND CONCLUSION: All the patients were followed up for 36-72 months. The absorption of calcium sulphate appeared to be absorbed earlier, the earlier absorption appearance could be observed as earlier as 1。
