异种骨和人工骨修复骨肿瘤性骨缺损方志伟，李舒，樊征夫，白楚杰，刘佳勇，薛瑞峰，张路北京大学肿瘤医院暨北京市肿瘤防治研究所，骨与软组织肿瘤科，恶性肿瘤发病机制及转化研究教育部重点实验室，北京市100142XenograftandcalciumsulphateintreatingbenignbonetumorFangZhi-wei,LiShu,FanZheng-fu,BaiChu-jie,Liu激a-yong,XueRui-feng,ZhangLuKeyLaboratoryofCarcinogenesisandTranslationalResearch(MinistryofEducation),DepartmentofOrthopedicOncology,PekingUniversityCancerHospitalInstitute,Beijing100142,China摘要背景：自体植骨是修复骨肿瘤刮除后骨缺损最理想的材料和方法，但存在增加手术创伤，取骨部位的后遗症如感染和疼痛及自体骨的取量有限等缺点。目的：分析硫酸钙人工骨和异种骨修复良性骨肿瘤刮除后骨缺损的临床疗效。方法：选择26例良性骨肿瘤患者，其中骨巨细胞瘤8例，内生软骨瘤5例，纤维组织细胞瘤4例，骨纤维异样增殖症3例，非骨化性纤维瘤2例，骨囊肿2例，动脉瘤样骨囊肿和软骨母细胞瘤各1例。12例采用单一硫酸钙骨粒填充肿瘤切除后的骨缺损，6例采用单一异种骨条填充肿瘤切除后的骨缺损，8例采用硫酸钙骨粒+异种骨条填充肿瘤切除后的骨缺损。治疗后1周内、3个月、1年拍X射线片检查，了解植骨愈合情况。结果与结论：治疗后随访36-72个月，发现硫酸钙骨粒的降解发生较早，一般治疗后1个月就开始出现骨粒降解，3个月大部分已降解完毕并有骨替代发生，1年骨修复塑型良好；异种骨条3个月后降解并有骨替代发生，植骨充填物边缘模糊，6个月后骨缺损及充填物之间边界变模糊，有融合现象，1年骨缺损内密度均匀，骨小梁形成明显，骨修复良好；骨粒+骨条混合植骨者介于单纯硫酸钙骨粒和单纯异种骨条之间，出现骨粒部分先降解先修复、骨条部分后降解后修复，一般术后1年达到骨性愈合。说明硫酸钙人工骨和异种骨在骨肿瘤性骨缺损修复应用中的效果良好，在良性骨肿瘤刮除后植骨可以替代自体骨植骨。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；组织工程全文链接：关键词：生物材料；骨生物材料；骨肿瘤；人工骨；硫酸钙；异种骨；植骨；Abstract：BACKGROUND:Autologousbonegraftisthebestmethodtorepairbonedefectsaftertumorcurettage,butitsshortcomingsareasfollows:increasedsurgicaltrauma,sequelaeatbonegraftsitesuchasinfectionandpain,andalimitedamountofautologousbone.OBJECTIVE:Toanalyzetheeffectivenessofxenograftandcalciumsulphateartificialboneintreatingbonedefectsafterbenignbonetumorremoved.METHODS:Totally26casesofbenignbonetumorwereselected,including8casesofgiantcelltumor,5ofenchondroma,4offibroushistiocytoma,3ofbonefibrousdysplasia,2ofnon-ossifyingfibroma,2casesofbonecysts,1ofaneurysmalbonecystand1ofaneurysmalbonecystand1caseofchondroblastoma.Ofthe26cases,12casesunderwentcalciumsulphatepelletsalonetofillbonedefectsafterbenignbonetumorremoved,6casesweresubjectedtoxenograftalone,and8casesweretreatedwithcalciumsulphatepelletscombinedwithxenograft.TheX-raysweretakenat1week,3months,and1yearaftertheoperationinallpatientstoassessthebonehealingprocess.RESULTSANDCONCLUSION:Allthepatientswerefollowedupfor36-72months.Theabsorptionofcalciumsulphateappearedtobeabsorbedearlier,theearlierabsorptionappearancecouldbeobservedasearlieras1monthaftertheimplantation,andmostcalciumsulphatewasabsolvedandreplacedbynewboneat3monthsaftertheoperation.Thexenograftbonewasdegradedat3monthspostimplantationandnewboneformed.Osseointegrationofthegraftwasobservedattheperipheryoftheimplantat6monthspostimplantation.Oneyearpostimplantation,trabecularbonewasobservedatthesitewithuniformbonedensity.Inthecombinedgroup,thecalciumsulphatepelletswereabsorbedearlierandnewboneformedearlierthanthecalciumsulpha...