|摘要||目的 评价新型硫酸钙和脱钙骨基质混合物作为骨移植替代物的临床应用效果. 方法 2005年2月至2008年2月采用新型人工骨移植治疗51例患者,按照植入物不同分为两组:人工骨与自体骨混合组21例,即植人硫酸钙和脱钙骨基质混合物加自体骨;单纯人工骨组30例,只植入硫酸钙和脱钙骨基质混合物.术后定期复查,观察人工骨吸收和新骨生长情况. 结果 51例切口一期愈合,无局部红肿、渗出.3例患者失访,48例随访6～36个月,平均16个月.单纯人工骨组术后4周可见人工骨部分吸收,颗粒形态模糊,术后8～12周(平均9.6周)完伞吸收,可见新生骨质,术后8～16周(平均11周)骨性愈合.人工骨与自体骨混和组术后8～12周(平均11.5周)人工骨颗粒完全吸收,骨折不愈合患者术后14～24周(平均19周)获骨性愈合,其余患者术后9～20周(平均13周)获骨性愈合. 结论 新型人工骨能够发挥增加移植物容量、促进骨生成的作用,无局部不良反应,是一种安全有效的骨移植替代物.
Objective To assess the clinical effect of a new mixture of calcium sulfate and dem-ineralized bone matrix as bone substitute. Methods We treated 51 patients using the synthetic granules of calcium sulfate and demineralized bone matrix from February 2005 to February 2008. Of them, 21 cases were treated with a combination of synthetic granules and autogenous bone. The other 30 bone defects were filled with synthetic granules alone. All patients were followed up periodically. The absorbability of the bone graft substitute and the new bone formation were observed radiologieally. Results No complications were encountered postoperatively and all wounds healed with no swelling or effusion. All patients, except 3, had a clinical follow-up for a mean period of 16 (6 to 36) months. In the group of granules alone, the granules were absorbed partially and their margins were blurred at 4 weeks after operation. No granules were visible and new bone was seen 8 to 12 weeks postoperatively (average, 9.6 weeks). Clinical fracture healing was gained 8 to 16 weeks postoperatively (average, 11 weeks). In the group of synthetic granules and autograft, the granules were absorbed completely 8 to 12 weeks postoperatively (average, 11.5 weeks) . The patients with bone nonunion obtained bone healing 14 to 24 weeks postoperatively (average, 19 weeks), while the other patients had bone healing 9 to 20 weeks postoperatively (average, 13 weeks). Conclusion Since the new bone graft substitute has strong osteoconductive and osteoinductive properties and no risk of local complications, it can be used effectively to repair bone defects.|