应用酒精贮存同种异体骨修复骨缺损54例分析

An Analysis of 54 Cases of Clinical Application of Alcohol for Storing-Allogeneic Bone in Repair of Bone Defects

目的 通过对 54例应用酒精贮存同种异体骨的临床分析和文献资料复习 ,探讨酒精贮存同种异体骨临床应用的可行性和优点。方法 将术中不用多余的骨骼 ,外伤截肢术废弃残肢的干净骨骼经无菌处理后贮存于 75%酒精溶液中备用 ,每两周更换酒精 1次。供骨者必须是健康无传染病者 ,受骨者在彻底清除病灶后 ,取相应贮存的异体骨加工成形后植入 ,大段移植或不稳定者加以内或外固定 ,术后相应治疗。本组应用 54例 ,包括常见的良性或中间性骨肿瘤、骨瘤样病变及慢性骨髓炎术后的骨缺损。最长的异体骨有 1 6cm (股骨慢性骨髓炎术后大段缺损 ) ,多数为小块移植。结果 54例经平均随访 42个月 ,50例愈合 (占 92 .6% ) ,包括移植 1 6cm大段异体骨 1例。治愈者的有 :内生软骨瘤1 5例 ,骨囊肿 1 3例 ,骨纤维异样增殖症 8例 ,软骨母细胞瘤 2例。骨巨细胞瘤 8例 ,治愈 7例 ,复发 1例 ;动脉瘤样骨囊肿 3例 ,治愈 2例 ,复发 1例 ;慢性骨髓炎 5例 ,治愈 3例 ,感染 2例。结论 复习有关酒精贮存异体骨的研究和临床应用文献 ,结合本组的资料 ,可以说明酒精贮存异体骨应用于临床是切实可行的 ,而且简易、经济 。

Objective:Through the clinical analysis of application of 54 cases with allogeneic bone stored in alcohol and review of literatures and data,the feasibility and advantage of clinical application of allograft stored in alcohol was explored.Methods:Surplus skeleton from operation and abandoned stump from injury amputation were cleaned and treated in sterility and then stored in 75% alcohol for ready for use.Alcohol was changed each time every 2 weeks.Bone donor should be healthy without any infection.After cleaning foci,allogeneic bone was transplanted into bone recipient with relevant bone processing plasticity.Internal or external fixation was carried for the patients with large segment transplantation or with instability and relevant treatment were carried out postoperatively.The above mentioned 54 cases included benign or middle bone tumor,osteomatoid and bone defects after operation of chronic osteomyelitis.The longest allogeneic bone was 16cm(great mass of defect after operation of chronic ostesmyelitis of femur)and the most were small mass transplantation.Results:54 cases were followed up for the average 42 months.Among them 50 cases were cured(92 6%)including 1 case with 16cm great segment transplantation of allograft,15 of enchondroma,13 of bone cyst,8 of fibrous hyperplasia of bone and 2 of chondrobla stoma.Among 8 of giant cell tumor of bone 7 cases were cured and 1 case relapsed.Among 3 cases of artery tuberculate bone cyst 2 cases were cured and 1 case relapsed.Among 5 cases of chronic osteomylitis 3 cases were cured and 2 were infected.Conclusion:Reviewing the research on alcohol storing allogeneic bone and the data of clinical applications and combinating the above mentioned datum,it may indicate that alcoholstoring allogeneic bone is feasible,simple,economic and relieve patients 'painand reduce expenses.