摘要
目的:观察纳米羟基磷灰石/胶原(简称纳米人工骨)骨材料植入骨缺损后,局部和全身的反应、植入后的骨修复时间,评估纳米人工骨的临床效果。方法:选择2003-03/2004-06在江苏大学附属医院骨科收治的骨缺损患者29例,男21例,女8例;年龄10～83岁。其中骨折后骨缺损22例,经骨折切开复位适宜的内固定,骨缺损处植入纳米羟基磷灰石/胶原骨;骨折后骨不连4例,将骨折端瘢痕及硬化骨清除,打通髓腔后植入纳米羟基磷灰石/胶原骨;骨瘤样病损3例,病灶刮除后植入纳米羟基磷灰石/胶原骨。上述病例术中材料植入量0.4～3.0g。连续12个月的临床观察随访,行X射线摄片检查。结果:29例患者切口均一期愈合。除1例胫骨骨折术后失访,其余28例连续12个月复诊随访。①患者纳米羟基磷灰石/胶原骨植入后X射线摄片观察结果:术后1～3个月材料植入区与缺损周围的骨组织之间界限模糊;3～6个月材料植入区内有明显的新骨长入,骨修复材料与骨组织融合成一体,密度接近正常骨组织,达到骨性连接,骨缺损己基本修复。6～12个月植骨塑形改建。②不良事件及副反应:28例复诊随访时,全身无发热反应,纳米羟基磷灰石/胶原骨植入部位的局部无不良反应。其中2例骨折患者术后2个半月因外伤或过早负重,致内固定钢板折断再骨折,予重新手术复位固定。结论:纳米羟基磷灰石/胶原骨具有良好的生物相容性,是安全的新型骨缺损填充材料;纳米人工骨材料植入骨缺损处3～6个月可形成骨性连接,6～12个月骨结构塑形改建,且局部无不良反应。
AIM： To observe the reaction of local and whole body and the healing time with nano-hydrexyapatite/collagen （NHAC） as a bone graft substitute for repair of bone defects, and evaluate the clinical effect of NHAC.
METHODS： Twenty-nine patients including 21 males and 8 females aged 10-83 years, admitted to Department of Orthopedics, Affiliated Hospital of Jiangsu University were selected between March 2003 and June 2004. There were 22 cases with bone defects caused by crushed fracture, the NHAC was implanted in the defects after surgical procedure and internal fixation; there were 4 cases with nonunion of fractures, the NHAC was implanted after excising the scar and ossified tissue in fracture and reaming the marrow cavity; there were 3 cases with bone tumor-like defects, NHAC was implanted in defects after excising the tumor-like tissue. The implantation amount was averaged from 0.4 to 3.0 g. Clinical and X-ray photograph assessments were performed consecutively during the follow-up of 12 months.
RESULTS： All of the incision in 29 cases obtained the primary healing. Except one case with fracture of tibia, all the rest 28 cases were followed up for 12 months. ①Results of X-roentgenograph after implantation of NHAC： There was vague bound between the implanted site and bone tissue around defects 1 to 3 months after operation; from 3 to 6 months after operation, new bone was found in implanted parts, and the graft material was fused with bone tissue, the bone density was near to normal tissue, the defects were almost repaired; during 6 to 12 months, the patients were given bone molding and reconstruction.②Bad events and adverse reactions： No fever was found in the 28 patients during follow up, and there was no adverse reaction in the implanted site of NHAC. Two of them were re-fracture and with broken fixator because of early removal of the external fixator or trauma.
CONCLUSION： NHAC has good biocompatibility and biodegradability; it is a safe, effective bone graft substitute material for the filling of defects. NHAC forms bony connection after implanted in bone defects for 3-6 months, and mould bone structure from 6-12 months without any adverse reaction.
出处
《中国临床康复》
CSCD
北大核心
2006年第37期51-53,共3页
Chinese Journal of Clinical Rehabilitation
