自体外周血干细胞与脱钙骨复合移植修复骨缺损的临床应用

Clinical application in repair of bony defects by grafting of autologous peripheral blood stem cell combine with demineralized bone matrix

目的 :观察自体外周血干细胞 (APBSC)与脱钙骨 (DBM )复合移植治疗良性骨肿瘤术后骨缺损的疗效。方法 :对 12例骨肿瘤患者 ,手术切除骨肿瘤脱钙骨填充骨缺损 ,术后第 7天行骨髓动员 ,每天皮下注射特尔立 3 0 μg/kg ,连续 3d ,第 4天静脉滴注 10mg地塞米松后采集APBSC。在X线电视透视下将一枚骨穿针准确穿入骨缺损部位 ,然后抽取自体外周血干细胞即可注入骨缺损部位。通过术后连续X线片 ,了解其骨缺损修复能力。结果 :12例病人术后得到随访 ,时间为 4～ 16个月 ,在 2～ 4个月以内均开始有不同程度的骨化 ,成骨效应满意。结论 :自体外周血干细胞 (APBSC) /脱钙骨 (DBM )复合移植是一种治疗骨缺损有效的新方法。

Objective: To observe the effect of repairing segmental bony defects by the grafting of autologous peripheral blood stem cells (APBSC) and demineralized bone matrix (DBM). Methods: 12 patients were reported,the bony defects of the benign bone tumors resections were repaired by DBM,marrow mobilization at 7 days postoperatively,GM-CSF 3 0 μg/kg was subcutaneously injected daily for 3 days.On the 10th day,APBSC were harvested on the 3rd hour after intravenous adminstration of 10mg dexamethasome.A marrow needle was inserted into the site of the bone defects under the X-ray,APBSC were aspirated and injected immediately into the site of bone defects.The ability of repairing segmental bony defects were observed with serial radiography. Results: 12 cases were followed up from 4 to 16 months after operation.All the cases healed primaily,variously degrees of ossification were found in the cases from 2 to 4 months after operation. Conclusion: APBSC/DBM is a effective and new method for the repair of bony defects.