多孔磷酸三钙修复良性骨肿瘤骨缺损的临床研究

摘要

Objective To assess the clinical outcome of porous tricalcium phosphate (TCP) in repairing bone defects due to benign or aggressive tumor resection. Methods A total of 19 patients underwent benign or aggressive bone tumor resection and grafting with porous TCP from September 2007 to January 2010, including 12 males and 7 females, with the average age 22.4 years ranging from 3 to 58 years at surgery. After operation, the VAS score was used to evaluate the easement of pain. The Lane-Sandhu score was used to evaluate the bone healing of defects. The change of gray scale of grafting area in plain X-ray images was used to assess the degradation of porous TCP. Results The VAS scores among the 4 groups (preoperation, 1 week after operation, 12 weeks after operation and 24 weeks after operation ) showed significant difference (P＜0.01) which showed the gradually relief of pain after surgery. The Lane-sandhu score among the 4 groups showed significant difference (P＜0.01) which showed the obvious bone repair effect. In our viewpoints, the porous TCP should be implanted loosely with no impaction bone grafting. Conclusion The porous tricalcium phosphate is an ideal material for repairing defects after tumor resection.%目的 评价多孔磷酸三钙(Tricalcium Phosphate,TCP)治疗良性或侵袋性骨肿瘤骨缺损临床效果.方法 2007年9月至2010年1月对19例良性或侵袭性骨肿瘤患者采用多孔磷酸三钙修复骨缺损,其中男12例,女7例.年龄3～58岁,平均年龄22.4岁.随访3～30月,平均13月.采用VAS评分反应疼痛缓解程度,X线检查并Lane-Sandhu评分评定骨愈合情况,分析X片中植骨区灰度变化评估TCP的降解情况.结果 VAS评分术前、术后1周、术后12周、术后24周各组间总体差别比较P＜0.01,说明术后疼痛逐渐缓解.Lane-sandhu评分三个时段差异P ＜0.001,说明人工骨随时间推移有明显的骨修复效果.认为手术中应当将多孔TCP人工骨松散放置,不要施加任何挤压力.结论 多孔磷酸三钙人工骨可以用作良性或侵袭性骨肿瘤骨缺损的修复.