应用 GBR 生物膜联合羟基磷灰石生物陶瓷与自体静脉血在颌骨局部缺损中的临床疗效观察

摘要

Objective To investigate the clinic effect of GBR biofilm combined wiht biodegradable coral-hydroxyapatite ceramic and autologous venous blood in treatment of bone partial defect.Methods 32 patients suffering cyst of jaw and benign tumor of jaw per-formed.The therapy of GBR biofilm combined with biodegradable coral-hydroxyapatite ceramic and autologous venous blood in bone partial defect were on them.The jaw bone defect ranged from 1 .5 cm ×1 .5 cm ~1 .5 cm ×5.5 cm.Results 29 patients were healed with stageⅠafter operation.3 patients were token out stitches after 10-12 days and there appeared partial suture zone crakes and artifi-cial bone granules leak.No of them was wound infection or rejection 6 months followed after operation,the gap between biodegradable coral-hydroxyapatite ceramic disappeared basically,and the defect density tended to be more consistent with the host bone mineral den-sity.After 1 -2 years ,the boundary of jaw neoplasm disappeared completely.The packed material,the new bone tissue and the surroud-ing host bone have grown well.We can also obverse the bone reticulate structure.Conclusions The GBR biofilm combined with biode-gradable coral-hydroxyapatite ceramic and autologous venous blood can used in the bone partial defect.The advantage can overcome the deficiency of using alone.The can repair effectively the type of partial bone defect.%目的：评价 GBR 生物膜联合羟基磷灰石生物陶瓷与自体静脉血在颌骨局部缺损中的临床疗效。方法32例颌骨囊肿、颌骨良性肿瘤的患者，采用 GBR 生物膜联合羟基磷灰石生物陶瓷与自体静脉血治疗颌骨局部缺损，颌骨缺损范围为1．5 cm ×1．5 cm ～1．5 cm ×5．5 cm。结果术后29例患者切口Ⅰ期愈合；3例患者10～12 d 延期拆线，均有部分缝合区裂开，人工骨粉颗粒溢漏，32例患者均未发生术后刀口感染或排异反应。术后6个月，羟基磷灰石生物陶瓷颗粒之间间隙基本消失，缺损区密度与宿主骨密度趋于一致。术后1～2年，原颌骨肿物边界完全消失，充填材料与新生骨组织及周围宿主骨生长良好，可见正常的骨小梁网纹结构。结论将 GBR 生物膜联合羟基磷灰石生物陶瓷与自体静脉血应用于颌骨局部缺损，可以使三者优势最大限度的发挥出来，克服了单独使用所存在的不足，可有效的修复临床上常见的颌骨局部缺损类型。