rhBMP-2在脊柱融合术中安全性的研究进展

发布时间：2018-11-26 21:16

【摘要】：背景:自rh BMP-2被发现以来,一直是骨移植材料的研究焦点,但因其未能广泛应用于临床,关于其安全性的讨论只能停留在理论阶段。近年来随着rh BMP-2被越来越广泛的应用在脊柱融合术中,有关其不良事件的报道在临床也中越来越常见。其常见并发症包括:神经根炎症反应、异位骨化、骨溶解,以及潜在的致癌效应,还包括男性ALIF术后的泌尿系统事件。就其安全性问题,许多学者提出了质疑。本文就rh BMP-2在脊柱手术中安全性的最新研究进展作一综述。解及建议。目的:本研究的目的是通过复习文献,总结rh BMP-2在脊柱融合术中安全性的研究进展,以提高对该产品相关并发症的认识,从而对其临床的安全性有进一步了方法应用CNKI、万方全文数据库、Pubmed、Springerlink数据库检索系统以“重组人体骨形态发生蛋白(rh BMP-2);腰椎融合;并发症;骨溶解;逆行性射精”为关键词分别或联合检索相关文献,按其因素不同分别进行归类总结。结果:对相关文献进行分析总结后,得出rh BMP-2在腰椎融合术中可与新发神经根损伤、异位骨化、骨溶解、逆行性射精以及潜在致癌效应有关。在颈椎中可能导致颈前水肿及吞咽困难、骨溶解及移植物沉降、迁移、血肿形成。结论:rh BMP-2在脊柱手术中应当暂且严格限制其适应症,不推荐作为常规应用于脊柱融合术中。仅建议用于那些植骨不融合的风险大过使用rh BMP-2带来的风险的患者,比如:接受翻修手术的假关节形成患者、老年骨质疏松症患者、存在长期吸烟等增加骨质愈合难度的患者以及自体骨的质量较差等患者。总之,在应用rh BMP-2之前,要慎重思考、权衡利弊。
[Abstract]:Background: rh BMP-2 has been the focus of bone graft materials since it was discovered, but because it has not been widely used in clinical practice, the discussion about its safety can only stay in the theoretical stage. In recent years, rh BMP-2 has been more and more widely used in spinal fusion, and its adverse events are more and more common in clinic. Common complications include nerve root inflammation, ectopic ossification, osteolysis, and potential carcinogenic effects, as well as urinary system events after ALIF in men. Many scholars have questioned its safety. This article reviews the latest research progress on the safety of rh BMP-2 in spinal surgery. Solutions and suggestions Objective: the purpose of this study is to review the literature, summarize the research progress of rh BMP-2 safety in spinal fusion, in order to improve the understanding of the complications associated with the product, so as to further the clinical safety of the application of CNKI,. Wanfang full-text database, Pubmed,Springerlink database retrieval system to "recombinant human bone morphogenetic protein (rh BMP-2);" Lumbar fusion; complications; osteolysis; retrograde ejaculation "respectively or jointly search for relevant literature, according to their factors are classified and summarized." Results: it was concluded that rh BMP-2 in lumbar fusion could be related to the injury of new nerve root, ectopic ossification, osteolysis, retrograde ejaculation and potential carcinogenic effect. Anterior cervical edema and dysphagia, osteolysis and graft sedimentation, migration and hematoma formation may occur in the cervical spine. Conclusion: the indication of rh BMP-2 should be strictly limited in spinal surgery, and it is not recommended to be used in spinal fusion. It is recommended only for patients who are at greater risk of bone graft non-fusion than use of rh BMP-2, such as pseudoarthropoiesis patients undergoing revision surgery, and elderly patients with osteoporosis. Patients with long-term smoking increased bone healing difficulty and poor quality of autogenous bone. In a word, before applying rh BMP-2, consider carefully and weigh the advantages and disadvantages.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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