自体骨髓移植复合人工骨治疗骨缺损

背景：到目前为止，国内人工骨联合自体骨髓移植治疗新鲜骨折、骨缺损方面的基础与临床研究尚未见报道。 目的：分析自体骨髓移植复合人工骨修复四肢粉碎性骨折骨缺损的作用途径。 方法：42例四肢骨缺损患者按治疗方法分为3组，均采用内固定方法修复骨折骨缺损。复合组采用自体骨髓移植复合人工骨，人工骨移植组仅作单纯的人工骨移植，自体骨髓移植组仅将单纯的自体骨髓注射入骨缺损处。所有患者均行骨特异性碱性磷酸酶活性检测和影像学随访，观察骨痂形成及骨折愈合情况。 结果与结论：在内固定后第3，4，6周，复合组伤肢骨痂形成率、骨特异性碱性磷酸酶活性均显著高于人工骨移植组及自体骨髓移植组(P < 0.01)。提示自体骨髓移植复合人工骨较单纯的人工骨移植或自体骨髓移植更能促进早期骨痂反应，加速骨折后骨缺损愈合，缩短骨愈合时间及住院时间。

Treatment of bone defects with autologous bone marrow transplantation combined with bone allograft

BACKGROUND: Up to now, there are no reports about autologous bone marrow transplantation combined with bone allograft for fresh bone fractures and bone defects in China. OBJECTIVE: To investigate the mechanism of autologous bone marrow transplantation combined with bone allograft in the treatment of limb fractures. METHODS: Forty-two cases of limb fractures were randomly divided into three groups: combination group, bone allograft and autologous bone marrow transplantation groups. All patients underwent bone specific alkaline phosphatase (BSAP) and imaging follow-up to observe callus formation and fracture healing. RESULTS AND CONCLUSION: In the combination group, the rate of callus formation and activity of BSAP were both higher than those in the other two groups at 3, 4, 6 weeks after internal fixation (P < 0.01). The autologous bone marrow transplantation combined with bone allograft probably promotes the early-stage development of the callus, accelerates the bone healing, shorten the hospitalization staying.