胎儿骨在骨肿瘤切除术后骨缺损修复中的应用

APPLICATION OF FETAL BONE IN REPAIRING THE DEFECTED PART OF OSTEOMA RESECTION

目的观察骨肿瘤病灶清除后的腔穴性骨缺损，采用胎儿骨植入后的临床效果。方法将大月龄流产的胎儿，在８小时内无菌条件下切取四肢骨，浸泡于加庆大霉素的生理盐水中待用。１９９０年以来，对７例四肢骨肿瘤病灶清除后，骨缺损区采用胎儿骨植入填充。结果术后切口均Ⅰ期愈合。术后４周Ｘ线片示植骨区密度增加，１６周后骨缺损区完全修复，髓腔再通。随访８个月～５年，患肢功能基本恢复正常，无一例骨肿瘤复发。结论胎儿骨与成人骨的结构不同，胎儿骨的重吸收过程快，取代需要的时间短，骨诱导作用优于成人，骨的“爬行替代”作用较快，是良性骨肿瘤切除术后腔穴性骨缺损较好的修复材料。

Objective To investigate the clinical results used fetal bone repairing the defect after osteoma resection.Methods In 8 hours after abortion,the fetal bones of four limbs were cut and kept in the normal saline with gentamycin.Then the graft was storaged under 6℃～8℃ and the longest storage time was 48 hours.Since 1990,seven cases of osteoma had been cured with fetal bone graft.Among them,there were 5 males and 2 females,aged from 6 to 38 years,the bone defect volume ranged from 5.5 cm×3.6 cm×2.5 cm to 9.0 cm ×4.3 cm×3.2 cm.During operation, the osteoma was resected radically,then the defected cavity was impacted with prepared fetal bone.Results After operation,the general condition was good,all the incision wound healed primarily.Sixteen weeks after operation,the defected cavity was repaired completely and the medullary cavity reopened.Follow up for 8 months to 5 years,no recurrence or side effect were observed.Conclusion Because of the more rapid expansion and replacement effect,the stronger osteoinduction,and the lower immune response,the fetal bone is practical material for repairing the bone defect in osteoma resection.