骨多肽在颅骨缺损修复中应用研究

The Effects of Bone Morphogenetic Protein in Cranial Defect Repair

目的 探讨骨多肽生长素在离体颅骨瓣原位修复颅骨缺损中的作用。方法 采用离体颅骨瓣二期原位修复颅骨缺损 4 5例 ,共 4 8处 ,随机分为二组 ,其中多孔离体颅骨瓣 +骨多肽生长素 (简称组Ⅰ ) 2 6处 ,多孔离体颅骨瓣 (简称组Ⅱ ) 2 2处 ,通过术后各阶段影像学检查 ,对术后并发症 ,骨瓣骨质吸收及骨再生情况对照研究1～ 2年。结果 骨瓣部位无松动感 ,外观完美 ,影像学检查示接合处对合良好 ,缝隙渐消失 ,可见骨痂形成 ,组Ⅰ中骨瓣密度均正常 ,组Ⅱ中 5处骨瓣可见中央部密度降低 ,有部分骨质吸收现象 ,差异有显著性 (P <0 0 5 )。结论 骨多肽生长素局部应用能防止骨瓣吸收 ,促进新骨形成。

Objects To assess the effect of BMP(bone morphogenetic protein) in orthotopit grafting with an autogenous cranial bone flap in cranioplasty.Methods 45 cases (48 locations ) have been reconstructed by orthotopic repair with autogenous bone flap, it has been divided into two group;26 locations of them using porous autogenous bone flap plus BMP (group Ⅰ), 22 locations of them only using porous autogenous bone flap(group Ⅱ), All cases have been closely followed up for 1～2 years with X-ray and CT , including postoperative complications, absorption or regeneration of the bone flap. Results No flexible with the porous autogenous bone flap was seen , and the appearance was perfectly. The bone graft survival and besetting apposition were all right. The gap disappears gradually. It is obvious that the osteotylus come into being. The density of bone flap was normal in group Ⅰ. 5 cases in group Ⅱ have shown that bone partial absorption occurred and the density reducing in the center of the flaps,and with the significant difference. Conclusions The local application of BMP can avoid bone flap absorption and stimulate osteotylus morphofogenesis.