自体骨髓间充质干细胞微创治疗骨不连疗效分析

摘要

Objective To explore the therapeutic effects of treating none infectional fracture nonunion with bone mesenchymal stem cells ( BMSCs) from autologous bone marrow. Methods 16 patients suffering from fracture nonunion after limb fracture were enrolled in this study. BMSCs were aquired from their own iliac bone and cultured before they were percutaneously injected into the site of fracture nonunion. Regular X ray was used to observe the growth of bone callus at the fracture. Results 15 patient got healed. All the patients were followed up for 10-18 months, it took(8.2±2.5)weeks for the bone callus to appear,the fracture healed on(4.5±1.6) months.For the evaluation of fracture healing, the fracture of upper limb was according to the clinical scoring system of upper limb and the tibial fracture was according to Johner-Wruhs functional grading standard, the femoral fracture was according to Schatzker-Lambert scoring system, 12 cases were excellent, 3 cases were good, 2 cases were medium. No pyogenic infection、hematoma、DVT、tendon injurey、nerve injure or the complications related to the materials for fixing ocurred . Conclusions Treating none inflectional fracture nonunion minimally invasively with BMSCs from autologous bone marrow is effective and safe.%目的：探讨经皮自体骨髓间充质干细胞（BMSCs）移植术治疗四肢骨折非感染性骨不连的疗效。方法选取四肢骨折骨不连患者16例，自体髂骨获取其BMSCs后进行培养，经皮注射于骨不连部位。术后定期X线检查观察骨折断骨痂生长情况。结果15例愈合。全部病例得到随访，术后随访10~18个月，骨痂出现时间（8.2±2.5）周，骨折愈合时间（4.5±1.6）个月；上肢骨折按照临床上肢评分系统标准，胫骨骨折按照Johner-Wruhs 功能分级法评定标准，股骨骨折按照Schatzker-Lambert疗效评分系统等评估患肢恢复情况，优12例、良2例、可2例。均未发生注射创口化脓性感染、血肿、深静脉血栓形成、肌腱损伤、神经损伤以及固定材料失效与断裂等不良并发症。结论微创经皮自体BMSCs移植治疗非感染性四肢骨折不愈合有效而且安全。