含BMP的骨填充材料在骨肿瘤与瘤样病变手术中的应用

Clinical applications of bone stuff with BMP in operation of bone neoplasms and tumor-like legion

目的 探讨含骨形态发生蛋白(BMP)的骨填充材料在骨肿瘤及瘤样病变手术中的临床应用价值。方法 本组骨肿瘤及瘤样病变患者34例,男20例,女14例。骨填充材料(金骨威、金世植骨灵)应用方法:病灶刮除术骨缺损填充:灭活术后骨缺损填充;病灶切除后在骨干—假体结合部或骨干—同种异体1/4关节结合部植入骨填充材料。肿瘤及瘤样病变类型包括骨纤维结构不良、骨巨细胞瘤、骨肉瘤、骨囊肿、动脉瘤样骨囊肿、内生软骨瘤、软骨粘液样纤维瘤、非骨化性纤维瘤、骨母细胞瘤。观察患者术后全身及局部反应和影像学变化。结果 平均随访时间13.5个月。全部患者均无全身不良反应,除1例创口二期愈合外,余病例未见明显局部反应。X线片显示术后3～6个月即有填充材料降解和骨替代现象发生。结论 在骨肿瘤与瘤样病变手术中应用含BMP的骨填充材料代替自体或异体骨移植,不增加创伤,并发症少,术后基本无不良反应,且骨缺损修复效果满意,是理想的骨缺损填充材料。

Objective Clinical applications of bone stuff with BMP in operation of bone neoplasms were researched. Methods Thirty-four patients, 20 were male and 14 were female. The methods of bone stuff's applications: the bone stuff was implanted to repair bone defects after curettage or inactivation of focus, and was implanted in combining part between bone truck and prosthesis or homogenic variant 1/4 joint after excision of focus. Bone neoplasms and tumor-like legion include fibrous dysplasia, giant cell tumor of bone, bone cyst, osteosarcoma, aneurysmal bone cyst, enchondroma, chondromyxiod fibroma, non-ossifying fibroma, osteoblastoma. We observed the systemic and local reactions, and x-ray examinations postoperatively. The follow-up averaged 13.5 months. Results The bad system or local reaction was not found in all patients beyond the wound was second intention in one patient. The radiological examination showed there were resolving of absorbable stuff and replacing of bone after 3～6 months. Conclusion Bone stuff with BMP was applied for operation of bone neoplasm and tumor-like legion, there were no additional wound and seldom complications. There was no bad reaction after operation. The effects of repairing for bone defect were satisfied, the stuffwas perfect in repairing for bone defect.