同种异体骨移植用于骨缺损修复的应用现状

背景:创伤、感染和骨种瘤等原因导致的骨缺损难以自身愈合,目前治疗主要以骨移植为主。同种异体骨移植与实质脏器移植有所不同,诱发的免疫排斥反应相对较小,在临床上得到广泛应用。目的:总结中国同种异体骨移植治疗骨肿瘤、创伤性骨缺损和脊柱病变的现状。方法:应用计算机检索PubMed数据库及中国期刊网全文数据库1983-01/2011-10有关同种异体骨移植在各种骨科疾病中应用的文章,英文检索词为"bone allograft;bone trans plantation;repair;bone defect",中文检索词为"同种异体骨,骨移植,修复,骨缺损"。排除重复性及非中英文语种研究,共保留27篇文献进行综述。结果与结论:同种异体骨移植作为临床上修复骨缺损的方法,广泛用于骨折、骨肿瘤切除后导致骨缺损的修复、脊柱和关节疾患的治疗。虽然同种异体骨移植存在细菌和病毒感染、骨折、不愈合、延迟愈合等危险,但是由于它在修复骨缺损时具有的一些优点:结构类似于自体骨,排斥反应较异种骨轻,而且不存在自体骨移植引起的供区损伤、延长手术时间等问题,使其成为修复骨缺损的常用材料。

Application of allogeneic bone transplantation in the repair of bone defects

BACKGROUND:Bone defects caused by trauma,infection and bone tumor and other causes are difficult to self-healing,and at present,the treatment is mainly depend on bone transplantation.Allogeneic bone transplantation is different from real organ transplantation,allogeneic bone transplantation induced immune rejection is relatively small,and so it can be widely used in clinical surgery.OBJECTIVE:To review the application of allogeneic bone transplantation in the treatment of bone tumor,traumatic bone defects and spinal lesions.METHODS:A computer-based search was performed on the PubMed database and CNKI database from January 1983 to January 2011 for the biomechanics articles relate to application of allogeneic bone transplantation in the treatment of bone diseases.The key words were "bone allograft,bone transplantation,repair,bone defect" in English and Chinese.The repetitive articles and the articles not in English or Chinese were eliminated,and finally,a total of 34 articles were included to review.RESULTS AND CONCLUSION:Allogeneic bone transplantation as the clinical method to repair the bone defects has been widely used for the repair of the bone defects caused by fracture and bone tumor resection,as well as the spine and joint disorders.Although,allogeneic bone transplantation has the disadvantages of bacterial and viral infections,fractures,nonunion,delayed union,and other disadvantages,it has some advantages in the repair of bone defects,such as similar structure to autogenous bone and lighter rejection response,and there is no damage caused by autogenous bone transplantation and extending of the operation time.All the advantages make the bone allograft become the commonly used material for repair of bone defects.