中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (30): 4794-4799.doi: 10.3969/j.issn.2095-4344.0970

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

自体骨移植与人工骨移植材料修补颅骨缺损后的并发症

李建平1，杨 琳1，秦 毅2，蒋振东1，卢 巍1   

  1. 1遵义医学院珠海校区解剖学教研室，广东省珠海市 519041；2珠海市人民医院脊柱骨科病区，广东省珠海市 519000
  • 收稿日期:2018-05-02 出版日期:2018-10-28 发布日期:2018-10-28
  • 通讯作者: 卢巍，硕士，副教授，遵义医学院珠海校区解剖学教研室，广东省珠海市 519041
  • 作者简介:李建平，男，1980年生，硕士，讲师，主要从事神经生物学研究。
  • 基金资助:

    国家自然科学基金(81760416)：利用靶向神经移植术重建缺失肢体运动神经信息源及机制研究；遵义市科技计划项目(E-199)：截肢下肢神经功能重建方法及神经康复机制研究

Complications of skull repair with autologous and artificial bone grafts

Li Jian-ping1, Yang Lin1, Qin Yi2, Jiang Zhen-dong1, Lu Wei1   

  1. 1Department of Human Anatomy, Zunyi Medical College Zhuhai Campus, Zhuhai 519041, Guangdong Province, China; 2Department of Orthopedics, Zhuhai People’s Hospital, Zhuhai 519000, Guangdong Province, China
  • Received:2018-05-02 Online:2018-10-28 Published:2018-10-28
  • Contact: Lu Wei, Master, Associate professor, Department of Human Anatomy, Zunyi Medical College Zhuhai Campus, Zhuhai 519041, Guangdong Province, China
  • About author:Li Jian-ping, Master, Lecturer, Department of Human Anatomy, Zunyi Medical College Zhuhai Campus, Zhuhai 519041, Guangdong Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81760416; the Scientific Research Project of Zunyi Municipality, No. E-199

PDF

216

摘要：

文章快速阅读：

 

文题释义：
生物活性玻璃纤维增强复合材料：是一种多孔骨结合能力的生物材料，在动物模型中已证明其具有良好的生物相容性，能有效降低颅骨修补术中的并发症。有报道指出生物活性玻璃纤维增强复合材料移植10个月后，移植体开始转化为羟基磷灰石，且表面出现骨样组织，通过对移植体表面进行电镜扫描观察，发现周围间质中还含有成骨细胞形成的骨样组织。
生物活性材料：能够较明显地刺激人成骨细胞中骨形态发生蛋白2基因的表达，将胎儿成骨细胞置于生物活性玻璃上培养，能够提高骨桥蛋白、碱性磷酸酶、骨粘连蛋白和Cbfa1/Runx2、骨钙蛋白等基因的表达，生物活性玻璃同样可促进人成骨细胞中碱性磷酸酶、骨唾液酸糖蛋白、骨钙蛋白和骨粘连蛋白等编码基因的表达。
 
 
背景：国内对颅骨修补的最佳时机及不同颅骨移植材料引起的并发症少有报道。
目的：比较自体与人工骨移植材料对颅骨修补并发症的影响。
方法：纳入接受颅骨缺损重建治疗的患者62例，其中男40例，女20例，年龄(48.4±10.3)岁，根据骨移植材料不同分为自体骨移植组(n=12)、生物活性FRC组(采用生物活性玻璃纤维增强复合材料修复，n=12)、羟基磷灰石组(n=20)和其他材料组(包括聚醚醚酮、聚甲基丙烯酸甲酯、聚乙烯及钛材料，n=18)。颅骨修补后1，6，12个月对患者进行随访，比较各组术后并发症的发生率。

结果与结论：①4组组内，开颅手术到修补手术时间间隔<3个月与>3个月的并发症发生率比较均无差异。4组间，开颅手术到修补手术时间间隔<3个月的并发症发生率比较无差异；自体骨移植组开颅手术到修补手术时间间隔>3个月的并发症发生率高于生物活性FRC组，其余组间两两比较无差异；②4组间颅骨修补后1，6个月正常愈合、次要并发症(术后需保守治疗)和主要并发症(需二次手术修复)，以及12个月正常愈合和次要并发症发生率无差异；颅骨修补后12个月的主要并发症，自体移植组、其他材料组高于生物活性FRC组(P < 0.05)，其余组间两两比较无差异；③结果表明，生物活性玻璃纤维增强复合材料修补颅骨缺损后的远期并发症发生率低，有更好的应用前景。ORCID: 0000-0002-3726-7070(李建平)

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

关键词: 移植, 颅骨修补术, 自体骨移植, 生物活性FRC, 羟基磷灰石, 国家自然科学基金, 生物材料

Abstract:

BACKGROUND: There are less domestic reports on the best timing for skull repair and the complications caused by different skull transplantation materials.

OBJECTIVE: To compare the impact of autologous bone grafts and artificial bone grafts on the complications of skull repair.
METHODS: Sixty-two patients undergoing skull repair, 40 males and 20 females, aged (48.4±10.3) years, were included. According to different graft materials, the patients were divided into autologous bone graft group (n=12), bioactive FRC group (bioactive glass fiber reinforced composite, n=12), hydroxyapatite group (n=20) and the group of other materials (including polyetheretherketone, polymethylmethacrylate, polyethylene and titanium materials, n=18). Patients were followed for 1, 6, 12 postoperative months, and the incidence of postoperative complications was compared between groups.

RESULTS AND CONCLUSION: (1) As regards the time interval from craniotomy to skull repair, in each group, there was no difference in the incidence rate of complications between the time interval of less than 3 months and of more than 3 months, while among the four groups, there was no difference in complication rates with the time interval of less than 3 months. The complication rate with the time interval of more than 3 months in the autologous bone graft group was higher than that in the bioactive FRC group, and there was no difference between other groups. (2) Among the four groups, there were no differences in the incidence rate of secondary complications (conservative treatment was needed after surgery) and major complications (secondary surgical repair was required) after normal healing of 1 and 6 months and the incidence rate of secondary complications after normal healing of 12 months. The incidence rate of major complications at 12 months after skull repair in the autologous bone graft group and other materials group was higher than that in the bioactive FRC group (P < 0.05), and there was no difference between other groups. Overall, our findings reveal that the incidence rate of long-term complications is lowered after skull repair with bioactive bioactive glass fiber reinforced composite, and therefore, this material may have better application prospect.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Bone Transplantation, Skull, Postoperative Complications, Tissue Engineering

中图分类号: