目的:探讨浓缩生长因子联合自体髂骨移植修复术对牙槽嵴裂患者相关生长因子及植骨效果的影响。方法:选择2016年7月-2017年10月笔者科室收治的60例牙槽嵴裂患者为研究对象,采用随机数字表法分为观察组和对照组,每组30例。对照组采用自体...目的:探讨浓缩生长因子联合自体髂骨移植修复术对牙槽嵴裂患者相关生长因子及植骨效果的影响。方法:选择2016年7月-2017年10月笔者科室收治的60例牙槽嵴裂患者为研究对象,采用随机数字表法分为观察组和对照组,每组30例。对照组采用自体髂骨移植修复术,观察组采用浓缩生长因子联合自体髂骨移植修复术。随访期间,比较两组患者龈沟液相关生长因子、最低边缘骨水平(MBL)、最小垂直骨桥高度(SLB)、最小骨宽度(SBW)、骨吸收率等指标。结果:随访6个月,观察组患者龈沟液血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)含量明显高于对照组(43.32±6.20 vs 35.52±5.44,40.78±6.14 vs 36.71±5.51)pg/μl(P<0.05);SLB、SBW、MBL明显高于对照组(10.52±1.32 vs 8.48±1.12,9.12±1.14 vs 6.23±0.82;8.64±1.25 vs 6.75±1.02,6.28±0.85 vs 4.25±0.72,2.62±0.31 vs 2.47±0.24,2.62±0.31 vs 2.79±0.32,2.47±0.24 vs 2.67±0.27)mm(P<0.05),骨吸收率明显低于对照组(12.45±1.52 vs 20.32±4.15,17.72±3.12 vs 25.42±4.36)%(P<0.05)。结论:浓缩生长因子联合自体髂骨移植术有助于刺激牙槽嵴裂患者龈沟液相关生长因子分泌,降低骨吸收率,提高植骨效果。展开更多
背景老年肱骨近端骨折是一种常见的脆性骨折,重建内侧柱稳定性是治疗的关键,但重建方式存在差异。目的比较新型解剖髓内支撑系统与钢板结合髂骨髓内支撑治疗老年肱骨近端骨折的疗效差异。方法回顾性分析解放军总医院骨科医学部2018年9月...背景老年肱骨近端骨折是一种常见的脆性骨折,重建内侧柱稳定性是治疗的关键,但重建方式存在差异。目的比较新型解剖髓内支撑系统与钢板结合髂骨髓内支撑治疗老年肱骨近端骨折的疗效差异。方法回顾性分析解放军总医院骨科医学部2018年9月-2021年6月收治的肱骨近端骨折老年患者。根据治疗方式分为新型解剖髓内支撑系统组和钢板结合自体髂骨移植组。比较两组手术时间、术中出血量、切口长度、复位质量、疼痛视觉模拟评分(visual analog scale,VAS)以及末次随访时的肩关节功能Constant-Murley评分、生活能力DASH(disability of the arm,shoulder,and hand)评分、并发症等方面的差异。结果共纳入47例老年肱骨近端Neer分型骨折患者,男12例,女35例;三部分骨折25例,四部分骨折22例。新型解剖髓内支撑系统组22例,钢板结合自体髂骨移植组25例,两组一般资料差异无统计学意义(P均>0.05)。平均随访时间为18.4个月,所有患者均获得骨性愈合,观察组的切口长度、术中出血量、手术时间均短于/少于对照组[(6.43±0.78)cm vs(10.74±0.81)cm,(192.27±55.02)mL vs(250±57.8)mL,(101.27±13.8)min vs(116.72±11.24)min],差异有统计学意义(P均<0.05)。术后3个月与术后第1天相比,观察组颈干角变化值小于对照组[(0.71±0.63)°vs(3.2±1.14)°,P<0.05]。两组在末次随访时VAS疼痛评分、Constant-Murley评分、DASH评分均无统计学差异(P>0.05)。结论与自体髂骨联合钢板组相比,新型解剖髓内支撑系统组具有创伤小、维持复位能力强等优点。展开更多
Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study inve...Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.展开更多
文摘目的:探讨浓缩生长因子联合自体髂骨移植修复术对牙槽嵴裂患者相关生长因子及植骨效果的影响。方法:选择2016年7月-2017年10月笔者科室收治的60例牙槽嵴裂患者为研究对象,采用随机数字表法分为观察组和对照组,每组30例。对照组采用自体髂骨移植修复术,观察组采用浓缩生长因子联合自体髂骨移植修复术。随访期间,比较两组患者龈沟液相关生长因子、最低边缘骨水平(MBL)、最小垂直骨桥高度(SLB)、最小骨宽度(SBW)、骨吸收率等指标。结果:随访6个月,观察组患者龈沟液血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)含量明显高于对照组(43.32±6.20 vs 35.52±5.44,40.78±6.14 vs 36.71±5.51)pg/μl(P<0.05);SLB、SBW、MBL明显高于对照组(10.52±1.32 vs 8.48±1.12,9.12±1.14 vs 6.23±0.82;8.64±1.25 vs 6.75±1.02,6.28±0.85 vs 4.25±0.72,2.62±0.31 vs 2.47±0.24,2.62±0.31 vs 2.79±0.32,2.47±0.24 vs 2.67±0.27)mm(P<0.05),骨吸收率明显低于对照组(12.45±1.52 vs 20.32±4.15,17.72±3.12 vs 25.42±4.36)%(P<0.05)。结论:浓缩生长因子联合自体髂骨移植术有助于刺激牙槽嵴裂患者龈沟液相关生长因子分泌,降低骨吸收率,提高植骨效果。
文摘背景老年肱骨近端骨折是一种常见的脆性骨折,重建内侧柱稳定性是治疗的关键,但重建方式存在差异。目的比较新型解剖髓内支撑系统与钢板结合髂骨髓内支撑治疗老年肱骨近端骨折的疗效差异。方法回顾性分析解放军总医院骨科医学部2018年9月-2021年6月收治的肱骨近端骨折老年患者。根据治疗方式分为新型解剖髓内支撑系统组和钢板结合自体髂骨移植组。比较两组手术时间、术中出血量、切口长度、复位质量、疼痛视觉模拟评分(visual analog scale,VAS)以及末次随访时的肩关节功能Constant-Murley评分、生活能力DASH(disability of the arm,shoulder,and hand)评分、并发症等方面的差异。结果共纳入47例老年肱骨近端Neer分型骨折患者,男12例,女35例;三部分骨折25例,四部分骨折22例。新型解剖髓内支撑系统组22例,钢板结合自体髂骨移植组25例,两组一般资料差异无统计学意义(P均>0.05)。平均随访时间为18.4个月,所有患者均获得骨性愈合,观察组的切口长度、术中出血量、手术时间均短于/少于对照组[(6.43±0.78)cm vs(10.74±0.81)cm,(192.27±55.02)mL vs(250±57.8)mL,(101.27±13.8)min vs(116.72±11.24)min],差异有统计学意义(P均<0.05)。术后3个月与术后第1天相比,观察组颈干角变化值小于对照组[(0.71±0.63)°vs(3.2±1.14)°,P<0.05]。两组在末次随访时VAS疼痛评分、Constant-Murley评分、DASH评分均无统计学差异(P>0.05)。结论与自体髂骨联合钢板组相比,新型解剖髓内支撑系统组具有创伤小、维持复位能力强等优点。
文摘Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.
