本文選題：股骨頭壞死　切入點(diǎn)：干細(xì)胞移植　出處：《中國(guó)組織工程研究》2017年22期

【摘要】：背景:股骨頭壞死治療方法繁多,但效果均未得到肯定及統(tǒng)一,如何提升股骨頭內(nèi)骨細(xì)胞成骨分化能力及提高股骨頭修復(fù)后的生物力學(xué)支撐,是臨床亟待解決的問(wèn)題。目的:探討采用預(yù)先提取自體骨髓基質(zhì)干細(xì)胞,經(jīng)體外培養(yǎng)擴(kuò)增后聯(lián)合帶血運(yùn)髂骨瓣轉(zhuǎn)移及多孔鉭棒植入治療股骨頭壞死的臨床療效。方法:收集2010年1月至2011年1月在大連大學(xué)附屬中山醫(yī)院就診并符合納入條件的28例成年非創(chuàng)傷性股骨頭壞死患者。預(yù)先抽取自體骨髓液,離心提取骨髓基質(zhì)干細(xì)胞,體外培養(yǎng)擴(kuò)增2周后備用。采用帶血運(yùn)髂骨瓣轉(zhuǎn)移、鉭棒植入將骨瓣騰起恢復(fù)股骨頭外形,并將預(yù)制的干細(xì)胞懸液注入植入髂骨瓣與股骨頭軟骨下間隙間。結(jié)果與結(jié)論:所有28例患者(36髖)均隨訪6-20個(gè)月,平均12個(gè)月。術(shù)后6個(gè)月及12個(gè)月隨訪時(shí)Harris髖關(guān)節(jié)功能評(píng)分、目測(cè)類(lèi)比評(píng)分均顯著優(yōu)于術(shù)前(P0.05);術(shù)后12個(gè)月時(shí)Harris髖關(guān)節(jié)功能評(píng)分高于術(shù)后6個(gè)月(P0.05),而這2個(gè)時(shí)間點(diǎn)的目測(cè)類(lèi)比評(píng)分差異無(wú)顯著性意義(P0.05);術(shù)后12個(gè)月隨訪髖關(guān)節(jié)結(jié)果優(yōu)13髖,較好15髖,良4髖,差4髖,優(yōu)良率90%。說(shuō)明自體骨髓基質(zhì)干細(xì)胞聯(lián)合帶血管蒂髂骨瓣移植鉭棒植入臨床功能評(píng)價(jià)成功率高,是治療股骨頭缺血性壞死的有效方法。
[Abstract]:Background: there are many methods for the treatment of femoral head necrosis, but the effect has not been confirmed and unified. How to improve the osteogenic differentiation ability of osteoblasts in femoral head and the biomechanical support after repairing femoral head is a clinical problem to be solved urgently.Objective: to investigate the clinical effect of pre-extraction of autologous bone marrow stromal cells (BMSCs) combined with vascularized iliac bone flap metastasis and porous tantalum rod implantation in the treatment of femoral head necrosis.Methods: from January 2010 to January 2011, 28 adult patients with avascular necrosis of femoral head were collected from Zhongshan Hospital affiliated to Dalian University.Bone marrow stromal cells were extracted from autologous bone marrow fluid by centrifugation and cultured in vitro for 2 weeks.With the transfer of iliac bone flap with blood, tantalum rod was implanted to restore the shape of femoral head, and the prefabricated stem cell suspension was injected into the space between iliac bone flap and subchondral space of femoral head.Results and conclusion: all 28 patients with 36 hips were followed up for 6-20 months with an average of 12 months.After 6 months and 12 months of follow-up, Harris hip function score was evaluated.Visual analogies scores were significantly better than preoperative scores (P 0.05), Harris hip function scores at 12 months after operation were higher than those at 6 months after operation (P 0.05), but there was no significant difference in visual analogy scores between the two time points (P 0.05).Better 15 hips, good 4 hips, poor 4 hips, excellent and good rate 90.The results showed that the success rate of tantalum rod implantation with autologous bone marrow stromal cells combined with vascularized iliac bone flap was high and it was an effective method for the treatment of avascular necrosis of femoral head.
【作者單位】： 大連理工大學(xué)電信學(xué)部生物醫(yī)學(xué)工程系;大連大學(xué)附屬中山醫(yī)院骨一科;
【基金】：國(guó)家十三五“國(guó)家重點(diǎn)研發(fā)計(jì)劃”項(xiàng)目(2016YFC1102000)~~
【分類(lèi)號(hào)】：R681.8

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