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使用冻干辐射灭菌同种异体骨并注入自体骨髓治疗单房性骨囊肿。

Management of unicameral bone cyst by using freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow.

作者信息

Datta N K, Das K P, Alam M S, Kaiser M S

机构信息

Professor Dr Nakul Kumar Datta, Professor and Chairman, Department of Orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka, Bangladesh.

出版信息

Mymensingh Med J. 2014 Jul;23(3):512-9.

Abstract

Unicameral bone cyst is a common benign bone tumor and most frequent cause of the pathological fracture in children. We have started a prospective study for that treatment of unicameral bone cyst by using freeze dried radiation sterilized bone allograft impregnated with autogenous bone marrow in the department of Orthopaedics, Bangabandhu Sheikh Mujib Medical University (BSMMU) during May 1999 to April 2012. Aim of this study was to see Freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow a satisfactory graft material in the treatment of unicameral bone cyst as well as factors such as patients age, sex, cyst size and site of lesion influence on cyst healing. A total 35 patients of unicameral bone cyst were operated. In this study out of 35 patients, male were 22(62.86%) and female were 13(37.14). Male Female ratio 22:13(1.70:1) Age of the patients ranging from 2 years 6 month to 20 years, mean age 12.18 years more common 11 years to 20 years 29(82.86%) patients. Common bones sites involvements are proximal end of Humerus 20(57.14%), proximal end of Femur 7(20 %), proximal end of Tibia 3(8.57%), Calcanium 2(5.71%), proximal end of Ulna 1(2.86%), shaft of Radius 1(2.86%) and Phalanx 1(2.86%). Final clinical outcome of unicameral bone cyst treated by thorough curettage of cavity and tightly filled with freeze dried radiation sterilized bone allograft impregnate with autogenous bone marrow in which healed (success rate) 88.57% (31) and recurrence rate is 11.43% (4). P value is <0.001. Follow up period was 6 month to 11 years. From our study it was realized that freeze dried radiation sterilized bone allograft impregnated with autogenous bone marrow is useful graft material for healing of the lesional area as well as restoring structural integrity for the treatment of unicameral bone cyst.

摘要

单房性骨囊肿是一种常见的良性骨肿瘤,也是儿童病理性骨折最常见的原因。1999年5月至2012年4月期间,我们在班加班杜·谢赫·穆吉布医科大学(BSMMU)骨科开展了一项前瞻性研究,采用冻干辐照灭菌同种异体骨并植入自体骨髓来治疗单房性骨囊肿。本研究的目的是观察冻干辐照灭菌同种异体骨并植入自体骨髓是否是治疗单房性骨囊肿的一种令人满意的移植材料,以及患者年龄、性别、囊肿大小和病变部位等因素对囊肿愈合的影响。共有35名单房性骨囊肿患者接受了手术。在本研究的35名患者中,男性22名(62.86%),女性13名(37.14%)。男女比例为22:13(1.70:1)。患者年龄从2岁6个月至20岁不等,平均年龄12.18岁,11岁至20岁更为常见,有29名(82.86%)患者。常见的骨部位受累情况为:肱骨近端20例(57.14%),股骨近端7例(20%),胫骨近端3例(8.57%),跟骨2例(5.71%),尺骨近端1例(2.86%),桡骨干1例(2.86%),指骨1例(2.86%)。通过对囊肿腔进行彻底刮除并紧密填充冻干辐照灭菌同种异体骨并植入自体骨髓来治疗单房性骨囊肿,最终临床结果显示愈合(成功率)为88.57%(31例),复发率为11.43%(4例)。P值<0.001。随访期为6个月至11年。从我们的研究中可以认识到,冻干辐照灭菌同种异体骨并植入自体骨髓是一种用于病变区域愈合以及恢复结构完整性以治疗单房性骨囊肿的有用移植材料。

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