纳米羟基磷灰石/聚酰胺66复合生物活性人工骨在肢体骨缺损应用87例

Curative effect of bioactive artificial bone by nano-hydroxyapatite /polyamide 66 in treating limb bone defect in 87 cases

目的观察纳米羟基磷灰石／聚酰胺66（n—HA／PA66）复合生物活性人工骨在四肢骨缺损术中填充植骨的安全性和临床疗效。方法对87例四肢骨手术后骨缺损，包括四肢松质骨暴力压缩骨折导致骨缺损和干骺端良性骨肿瘤术后骨缺损的患者，采用n—HA／PA66复合生物活性人工骨填充植骨。术前、术后1周及3、6、12个月分别摄x线片及CT，观察骨缺损的修复生长和植骨融合情况。结果随访6～28个月（平均8个月），伤VI均甲级愈合，无切口感染、非特异炎症反应和排斥反应；X线片和CT检查示：术后骨缺损区域填充良好，密度较松质骨稍低，材料与周围骨边界清楚；术后1个月，骨缺损区密度逐渐升高，可见植骨周围模糊，有少量新生骨痂形成；术后3个月，骨缺损区密度明显升高，植骨周围间隙开始向中心融合成片，更多新生骨痂影融合；术后6个月，骨缺损区密度明显升高，大量新生骨痂形成。临床骨愈合时间为术后3～7个月，平均3．8个月，愈合率为91．5％。结论纳米羟基磷灰石／聚酰胺66复合生物活性人工骨用于治疗四肢骨缺损，能与植骨区骨生长融合，无不良反应，疗效满意，是一种安全有效的骨缺损植骨填充材料。

Objective To observe the therapeutic efficacy and safety of the bioactive artificial bone by nano-hydroxyapatite/polyamide 66 （ n-HA/PA66 ） in treating the limb bone defect. Methods Eighty-seven cases of limb bone defect, which resulted from limb caneellated bone compression fracture or metaphysis innocuousness tu- morectomy ,were treated by padding bioactive artificial bone by uano-hydroxyapatite/polyamide 66 （n-HA/PA66 }. X ray examination and CT were taken preoperatively and at 1 week,3,6, and 12 months postoperatively to observe the bone repair and bone graft fusion. Results All patients were followed up for 8 months （ ranging 6-28 months）. All patients got good wound healing, without infection, non-specify inflammatory reaction, and serious complications. X-ray and CT examination revealed：bone defect area was well filled after operation, its bone density was lower than the cancellous bone and the materials had clear boundary with the surrounding bone;at 1 month after operation, the bone defect density gradually increased, showing blurring around the bone, and a small amount of callus formation ; at 3 months after operation,the bone defect density was significantly increased with more callus fusion;at 6 months after operation,the bone defect density was significantly increased with a large number of callus formation. The clinical bone healing time was at 3 to 7 months postoperatively （averaging 3.8 months） ,and the healing rate was 91.5%. Conclusion Bioactive artificial bone by nano-hydroxyapatite/polyamide 66 is a satisfactory and effective material for treating limb bone defect, which can get expecting fusion without any adverse effect.