硫酸钙人工骨填充骨肿瘤刮除后骨缺损的愈合情况

Healing state of bone defect with calcium sulfate artificial bone filling after curettage of bone tumor

目的：观察硫酸钙人工骨填充骨肿瘤刮除后骨缺损的愈合情况。方法：临床纳入行Osteo Set硫酸钙人工骨移植治疗的原发良性骨肿瘤患者47例,根据术后影像学检查对人工骨降解、吸收以及骨愈合生长情况等进行评估,评估38例含脱钙骨基质（DBM）以及9例未含DBM硫酸钙人工骨的愈合情况,研究植骨量对愈合情况的影响。另外,采用MSTS功能评分对关节功能进行评估。结果：47例患者经4~56个月的临床随访,平均随访时间为16.5个月。所有患者均发生人工骨颗粒与宿主骨间隙变模糊以及颗粒间变模糊,平均用时为3.2（1~6）个月;有37例患者重新塑形,平均用时为7.4（3~18）个月;人工骨愈合良好39例（82.98%）,未发生不愈合病例。含DBM硫酸钙与不含DBM硫酸钙人工骨植入患者的愈合率分别为89.47%、77.78%。植骨量≤5ml组愈合率为95.65%,平均用时为6.7（3~12）个月;植骨量〉5ml组愈合率为79.17%,平均用时为5.7（4~18）个月。两组患者愈合率以及愈合时间等无显著性差异（P〉0.05）;MSTS功能评分平均为29.0分。术后有2例出现伤口不愈合情况。结论：对于良性骨肿瘤切除后骨缺损的重建,硫酸钙人工骨的临床愈合效果较好,属于一种安全、有效的移植材料,值得推广。

Objective： To observe the healing state of bone defect with calcium sulfate artificial bone filling after curettage of bone tumor. Methods： All 47 patients with primary benign bone tumor receiving the Osteo Set calcium sulfate artificial bone graft were selected. According to the imaging examination,the degradation,absorption and healing of artificial bone were evaluated. The healing state for 38 DBM cases and 9 non- DBM cases were evaluated. The effect of bone mass in the healing state was studied. The joint function was evaluated by MSTS. Results： For 4 ~56months of follow- up,the average follow- up time was 16. 5months. The average time was 3. 2（ 1 ~ 6） months,all patients had the blurring condition between bone granules and spatium interosseum and blurring condition among bone granules. The average time was 7. 4（ 3 ~ 18） months for 37 reshaping cases. There were 39 favorable healing cases（ 82. 98%）. No case was found to be unhealed. The healing rate for DBM cases and non- DBM cases was 89. 47%and 77. 78%. The healing rate for bone mass（ ≤5ml） was 95. 65% while the average healing time was 6. 7（ 3 ~ 12）months. The healing rate for bone mass（ 〉5ml） was 79. 17% the average time was 5. 7（ 4 ~ 18） months. The healing rate and healing time of two groups was not significantly different（ P〉0. 05）. The average MSTS was 29. 0 scores. After surgery,two cases were not healed. Conclusion： For the reconstruction of bone defect after curettage of benign bone tumor,the calcium sulfate artificial bone filling is a safe and effective material and has a favorable healing effect.