自固化磷酸钙人工骨修复小儿局部骨缺损的临床应用

Clinical Application of Autosolidifiying Calcium Phosphate Cement in the Repair of Local Bone Defects in Children

目的:研讨自固化磷酸钙人工骨(Calcium Phosphate Cement,CPC)填充修复小儿局部骨缺损的临床意义。方法:选用CPC修复小儿骨缺损18例,年龄最小8个月,最大12岁。平均8岁。骨缺损部位:肱骨9例,胫骨6例,胫骨3例。病因:单纯性骨囊肿8例,骨纤维异常增生症5例,动脉瘤样骨囊肿4例,嗜酸性肉芽肿1例。骨缺损大小:最大7cm,最小2 cm,平均5 cm。CPC填充方式:单纯粉末7例,粉末十松质骨粒6例,粉末十条形骨块5例。CPC初步固化时间:最短15分钟,最长30分钟,平均20分钟。随访时间:13～27个月,平均18.5个月。结果:全组18例应用CPC后未见明显局部和全身不良反应。手术前后血pH值钙磷代谢无异常改变。X线片显示:CPC与宿主骨接触紧密,无脱落,术后3个月出现降解,新生骨形成。结论:CPC安全无毒,使用方便,易塑形,生物相容性好,能在体内降解,可以替代自体骨材料在小儿局部骨缺损应用。

Objective Our aim is to look into the clinical use of autosolidifying calcium phosphate cement(CPC) in the repair of local bone defects in pediatric patients. Method:We have recruited 18 cases of bone defects with CPC. Our youngest patient is 8 months old,and the oldest patient is 12 years old. The average age is 8 years old. The bone defects are located as follows:humerus in 9 cases,femur in 6 cases and tibia in 3 cases. Pathogenesis:bone cyst in 8 cases,fibrous dysplasia in 5 cases, aneurismal bone cyst in 4 cases and eosonophilic granuloma in 1 case. Size of defects range between 2cm and 7cm,average 5cm. CPC filling method;simple powder form in 7 cases,powder+cortical bone shaving 6 cases,powder + bone chip in 5 cases. CPC setting time :minimum 15 minutes, and maximum 30 minutes (average 20 minutes. The patient was followed up for 13-27 months; average 18.5 months :Results: No systemic or local adverse reaction is noted. Blood gas parameters, serum calcium and phosphate levels remained constant pre and post operativcly. Radiological examinations revealed that the implanted CPC is directly apposed to the bone. Degeneration occurred 3 months postoperatively and new bone is formed. Conclusion:CPC is safe and non-toxic ; with good biocompatibility and plasticity, it is a good substitute for autograft in repairing bone defects in children.