自体骨髓基质干细胞联合带血管蒂髂骨瓣转移多孔钽棒植入治疗股骨头缺血性坏死

发布时间：2018-04-03 13:22

本文选题：股骨头坏死　切入点：干细胞移植　出处：《中国组织工程研究》2017年22期

【摘要】：背景:股骨头坏死治疗方法繁多,但效果均未得到肯定及统一,如何提升股骨头内骨细胞成骨分化能力及提高股骨头修复后的生物力学支撑,是临床亟待解决的问题。目的:探讨采用预先提取自体骨髓基质干细胞,经体外培养扩增后联合带血运髂骨瓣转移及多孔钽棒植入治疗股骨头坏死的临床疗效。方法:收集2010年1月至2011年1月在大连大学附属中山医院就诊并符合纳入条件的28例成年非创伤性股骨头坏死患者。预先抽取自体骨髓液,离心提取骨髓基质干细胞,体外培养扩增2周后备用。采用带血运髂骨瓣转移、钽棒植入将骨瓣腾起恢复股骨头外形,并将预制的干细胞悬液注入植入髂骨瓣与股骨头软骨下间隙间。结果与结论:所有28例患者(36髋)均随访6-20个月,平均12个月。术后6个月及12个月随访时Harris髋关节功能评分、目测类比评分均显著优于术前(P0.05);术后12个月时Harris髋关节功能评分高于术后6个月(P0.05),而这2个时间点的目测类比评分差异无显著性意义(P0.05);术后12个月随访髋关节结果优13髋,较好15髋,良4髋,差4髋,优良率90%。说明自体骨髓基质干细胞联合带血管蒂髂骨瓣移植钽棒植入临床功能评价成功率高,是治疗股骨头缺血性坏死的有效方法。
[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.
【作者单位】：大连理工大学电信学部生物医学工程系;大连大学附属中山医院骨一科;
【基金】：国家十三五“国家重点研发计划”项目(2016YFC1102000)~~
【分类号】：R681.8

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