本文關(guān)鍵詞： 經(jīng)皮自體骨髓移植 四肢 骨干 骨折 延遲愈合 兒童　出處：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年06期 　論文類型：期刊論文

【摘要】：目的探討經(jīng)皮自體骨髓移植治療兒童四肢長骨干骨折術(shù)后骨延遲愈合的優(yōu)越性、安全性及療效。方法 2006-2014年我院應(yīng)用經(jīng)皮自體骨髓移植治療的四肢長骨干骨折術(shù)后骨延遲愈合患兒53例(骨折端均穩(wěn)定、無嚴(yán)重成角和短縮畸形),男性35例,女性18例,年齡1~16歲,平均年齡6.7歲。骨折部位:股骨20例,脛骨12例,肱骨10例,橈骨5例,尺骨5例,單純腓骨1例,均為外傷性骨折術(shù)后骨延遲愈合。按照骨折術(shù)后至第1次骨髓移植的時(shí)間分組,4~6個(gè)月共23例作為A組,6~8個(gè)月共30例作為B組。從髂前上棘處抽吸骨髓穿刺抽取骨髓液5~20 m L,平均12.7 m L,經(jīng)皮注入到X線定位的骨折延遲愈合處。術(shù)后定期攝X線片,觀察、比較骨折愈合情況。結(jié)果本組所有骨折延遲愈合均獲得隨訪,并隨訪至拆除內(nèi)、外固定后至少6個(gè)月,最終47例獲臨床愈合,愈合時(shí)間距第1次骨髓移植后3~10個(gè)月,平均5.8個(gè)月。未愈合6例,A組1例,B組5例,骨髓移植2次后骨折處無明顯骨痂生長,改為其他方法治療。兩組愈合時(shí)間和骨髓注射次數(shù)比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01),兩組最終治愈率比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論經(jīng)皮自體骨髓移植治療兒童四肢長骨干骨折術(shù)后骨延遲愈合是一種操作簡單、微創(chuàng)、安全、經(jīng)濟(jì)又切實(shí)可行的治療方法,且早期行自體骨髓移植,可加快骨折愈合,縮短療程,值得臨床推廣。
[Abstract]:Objective to evaluate the advantages of percutaneous autologous bone marrow transplantation (PMT) in the treatment of delayed bone healing after long bone fracture in children. Methods from 2006 to 2014, 53 children with delayed union of long bone fractures of extremities were treated with percutaneous autologous bone marrow transplantation. There were 35 males and 18 females with an average age of 6.7 years. The site of fracture included femur (n = 20), tibia (n = 12), humerus (n = 10) and radius (n = 5). Five cases of ulna and one case of fibula were all delayed union of bone after traumatic fracture. 23 cases were divided into group A according to the time of bone marrow transplantation from 4 to 6 months. From 6 to 8 months, 30 cases were used as group B. the bone marrow fluid was extracted from the anterior superior iliac spine by bone marrow puncture with an average of 12.7 mL. X-ray films were taken regularly after operation to observe and compare the fracture healing. Results all the fractures were followed up and followed up to the removal. At least 6 months after external fixation, 47 cases were clinically healed, and the healing time was 3 ~ 10 months after the first bone marrow transplantation, with an average of 5.8 months. There was no obvious callus growth at the fracture site after two bone marrow transplants. The healing time and times of bone marrow injection were significantly different between the two groups (P 0.01). Conclusion Percutaneous autologous bone marrow transplantation is a simple, minimally invasive and safe method for delayed bone healing after long bone fracture in children. Economic and feasible treatment and early autologous bone marrow transplantation can accelerate fracture healing and shorten the course of treatment.
【作者單位】： 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院骨一科 兒童發(fā)育疾病研究教育部重點(diǎn)實(shí)驗(yàn)室 兒科學(xué)重慶市重點(diǎn)實(shí)驗(yàn)室 重慶市兒童發(fā)育重大疾病診治與預(yù)防國際科技合作基地;
【基金】：國家臨床重點(diǎn)�？平ㄔO(shè)項(xiàng)目[國衛(wèi)辦醫(yī)函(2013)544] 重慶市衛(wèi)生和計(jì)劃生育委員會(huì)重點(diǎn)項(xiàng)目[渝衛(wèi)科教(2013)39號(hào)2013-1-029]~~
【分類號(hào)】：R726.8
【正文快照】： 大學(xué)附屬兒童醫(yī)院骨一科,兒童發(fā)育疾病研究教育部重點(diǎn)實(shí)驗(yàn)室,兒科學(xué)重慶市重點(diǎn)實(shí)驗(yàn)室,重慶市兒童發(fā)育重大疾病診治與預(yù)防國際科技合作基地)骨折愈合是一個(gè)復(fù)雜而連續(xù)的動(dòng)態(tài)生理過程,包括以下4個(gè)過程:細(xì)胞募集、骨誘導(dǎo)、調(diào)控、骨傳導(dǎo),需具備適宜的細(xì)胞(主要是成骨細(xì)胞)環(huán)境、足

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