NNB/BMP复合物在胫骨骨折不愈合治疗中的应用

The Application of NNB/BMP Complex in the Treatment of Ununited-tibia Fracture

目的 :验证天然型无机骨 (NNB)与骨形态形成蛋白 (BMP)复合物取代自体松质骨移植治疗胫骨陈旧性骨折及骨折不愈合的可行性。方法 :将NNB与BMP按 2 0∶1的比例 ,经化学方法制成NNB/BMP复合物 ,以 80例陈旧胫骨骨折及骨折不愈合为研究对象 ,本次手术到受伤时间平均 8.5个月 ( 4～ 2 4个月 ) ,平均年龄 3 5岁 ,随机分为对照组 3 0例 ,治疗组 5 0例 ,依治疗方法不同随机分为甲、乙二组 ,分别在骨折区域植入自体松质骨与NNB/BMP ,观察术后全身及切口局部反应及连续X线片表现。随访平均 19个月 ( 13～ 3 6个月 )。按Johner Wruh评分评价最终效果。结果 :治疗组与对照组愈合时间上有显著差异 ;治疗组甲与治疗组乙间无显著差异。结论 :NNB/BMP复合物具有与自体松质骨相同的促进骨愈合的生物学活性 ,是一种理想的促进骨折愈合的松质骨替代材料。

Objective: To prove the probability of NNB/BMP complex insteading of autograft bone in treating the ununited tibia fracture. Methods: The complex was obtained by chemical measures in the proportion of 20∶1 with NNB and BMP. The average age was 35 years old. The average time for the reoperation to the accident were 8.5 months. They were divided into control group with 30 patients and treating group with 50 patients by randomization. The latter was also divided into A group transplanted the autograft bone and B group transplanted the complex. The post operative systemlc and local reaction and the consecutive x ray films were observed. Average following time were 19 months. The function was assessed by the criterion of Johner Wruth. Results: There was a remarkable difference between the control group and the treating group in healing time, while the group A was similar to the group B. Conclusion:the NNB/BMP complex and autograft bone had the same role in speeding bone healing and the former was a good substitute for autograft bone.