新型人工骨修复材料在骨缺损修复中的临床研究

Clinical study of new artificial bone repair materials in bone defect repair

目的探讨新型人工骨修复材料和羟基磷灰石生物陶瓷在骨缺损修复中的临床效果,并评估新型人工骨修复材料的有效性和安全性。方法选取2019年12月至2021年4月中国人民解放军联勤保障部队第九二〇医院收治的50例骨缺损并接受骨缺损重建修复术患者,采用随机单盲法,分为新型人工骨修复材料组(实验组)和羟基磷灰石生物陶瓷组(对照组),每组25例。分别观察并比较术后1、6、12、24周两组患者植骨融合例数(植骨融合发生率),以及术前和术后1周血常规、中性粒细胞百分比、C-反应蛋白、血沉、肌酐、谷丙转氨酶、谷草转氨酶变化。结果术后46例患者生命体征均平稳、切口均I期愈合,无不良事件发生。两组间术后1周、6周、12周、24周植骨融合例数比较,差异无统计学意义(>0.05);两组间手术后1周白细胞计数(WBC)、中性粒细胞百分数(NEU)均升高,组内比较差异有统计学意义(<0.05),羟基磷灰石生物陶瓷组升高更加明显,组间比较差异有统计学意义(<0.05);余血常规检测指标组间、组内比较差异均无统计学意义(>0.05);两组谷丙转氨酶(ALT)、谷草转氨酶(AST)术后检查结果比较,组间、组内比较差异均无统计学意义(>0.05);实验组血肌酐术后明显降低,差异有统计学意义(<0.05),但组间比较差异无统计学意义(>0.05)。结论新型人工骨修复材料与羟基磷灰石生物陶瓷在四肢骨缺损修复中均表现出较好的临床效果;因此,新型人工骨修复材料可作为治疗四肢骨缺损中羟基磷灰石生物陶瓷的良好替代物。

Objective To investigate the effects of artificial bone repair materials and hydroxyapatite bioceramics on the repair of bone defects and to evaluate the effectiveness and safety of artificial bone repair materials.Methods A total of50 patients with bone defects treated in the 920 Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army from December 2019 to April 2021 were randomly divided into new artificial bone repair group(n=25)and hydroxyapatite bioceramic group(n=25).The bone graft fusion rates of the two groups were observed and compared at1 week,6 weeks,12 weeks and 24 weeks after operation.and the changes of blood routine,neutrophil percentage,C-reactive protein,ESR,creatinine,glutamic pyruvic transaminase and glutamic oxaloacetic transaminase before and1 week after operation were recorded.Results After operation,the vital signs of 46 patients were stable,the incisions healed in the first stage,and no adverse events occurred.There was no significant difference in the number of bone graft fusion between the two groups at 1 week,6 weeks,12 weeks and 24 weeks after operation,but the white blood cell count(WBC)and the percentage of neutrophils(NEU)increased significantly between the two groups,especially in the hydroxyapatite biological ceramic group.There was no significant difference in the results of glutamic pyruvic transaminase(ALT)and aspartate oxaloacetic transaminase(AST)between the two groups,and the serum creatinine in the experimental group decreased significantly after operation,but there was no significant difference between the two groups.Conclusion The new artificial bone repair materials and hydroxyapatite bioceramics showed good clinical effect in the repair of bone defect of four limbs.Therefore,the new artificial bone repair materials can be used as a good substitute for hydroxyapatite bioceramics in the treatment of limb bone defects.