自固化磷酸钙人工骨修复四肢骨缺损的初步临床应用

Clinical Application of Autosolidification Calcium Phosphate Cement to Repair Bone Defects: A Preliminary Report

目的研究自固化磷酸钙水泥（ＡＣＰＣ）人工骨修复非负重或低负重部位骨缺损的临床应用。方法应用ＡＣＰＣ人工骨修复３０例患者３６处非负重或低负重部位骨缺损，平均年龄２６．５岁。骨缺损大小平均为１５ｃｍ２，骨缺损病因依次为骨折、骨囊肿、骨纤维结构不良、内生软骨瘤和髂骨供骨区等。观察患者术中ＡＣＰＣ固化时间，术后全身及切口局部反应，血钙、磷值变化，Ｘ线片和ＣＴ扫描。随访平均时间９．４个月。结果全部患者未见明显全身反应，血钙、磷未见升高。Ｘ线显示植入的ＡＣＰＣ与宿主骨直接结合，全部或基本上恢复骨缺损处的解剖形状。其中３例ＡＣＰＣ固定时间延长；２例出现切口红肿；４例出现淡黄色透明渗出物；１例出现切口裂开，经换药处理后切口全部愈合。结论ＡＣＰＣ适用于人体非负重或低负重部位骨缺损的修复，其生物相容性好，无毒性，且可任意塑形。

Objective Clinical applications of the autosolidification calcium phosphate cement (ACPC) to repair human bone defects were researched. Methods We implanted the ACPC artificial bone to repair 36 bone defects of 30 patients at non-or low-weight bearing site, with the average age of 265 years, the average size of defects was 15 cm2 The bone defects were resulted from fracture, bone cyst, fibrous dysplasia, enchondroma, etc. We observed the ACPC setting time intraoperatively, the systemic annd local reactions, the fluctuations of werum calcium and phosphate, and signs of x-ray and CT examinations postoperatively. The follow-up averaged 94 months. Results Neither allergic or toxic reaction nor fluctuation of serum calcium and phosphate were found in all patients. The radiological examination showed that the implanted ACPC was directly bonded to the bone at the interface and the bone contour at the defect sites was successfully restored. The ACPC setting time extended in 3 cases, incision redness and swelling in 2, oozing light yellow fluids in 4, and wound dehiscence in 1 All wounds healed through dressing changes. Conclusions ACPC, with good biocompatibility and plasticity, no toxicity, is suitable for repairing human bone defects at low-or non-weight bearing site.