| 复合富血小板血浆的自体骨移植联合体外冲击波治疗骨不连 |
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投稿时间：2018-08-20
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| 期刊信息：《中国骨伤》2019年，第32卷，第5期，第434-439页 |
| DOI：10.3969/j.issn.1003-0034.2019.05.009 |
| 基金项目: |
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中文摘要:
目的：探讨自体髂骨移植、富集血小板血浆和体外冲击波治疗骨不连的临床疗效。
方法：2015年1月至2016年12月收治骨不连患者60例，男41例，女19例，年龄18~42岁，平均29岁。将骨不连患者分为自体骨移植治疗组（对照组）、自体骨移植与富血小板血浆联合体外冲击波治疗组（实验组），两组各30例，比较两组患者术后3个月骨痂生成情况、局部并发症发生状况、骨折最终生长状况以及术侧肢体Johner-Wruhs功能分级。
结果：55例患者获得随访，对照组27例，实验组28例，有5例患者失访。随访时间8~24个月。患者术后3个月骨痂评分，对照组明显低于实验组（P<0.05）。两组患者的髂骨获取部位及骨不连手术部位皮肤均无红肿及感染。对照组临床及骨性愈合时间均明显长于实验组（P<0.05）。实验组28例患者均达到了骨性愈合；对照组24例患者达到了骨性愈合，3例患者再次发生骨不连。对照组患侧肢体Johner-Wruhs功能分级优良率明显低于实验组（P<0.05）。
结论：自体髂骨移植与富集血小板血浆联合体外冲击波方案治疗骨折术后的骨不连有一定的疗效，可以显著改善新生骨的生成情况，是临床工作中治疗骨折术后骨不连的一种综合有用的方式。 |
| 【关键词】骨折,不愈合 骨移植 富血小板血浆 体外冲击波疗法 |
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| Treatment of nonunion with autologous bone transplantation combined with platelet-rich plasma and extracorporeal shock wave |
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ABSTRACT
Objective:To investigate the methods and clinical effects of autologous iliac bone transplantation,platelet-enriched plasma(PRP) and extracorporeal shock wave(ESW) in the treatment of nonunion.
Methods:From January 2015 to December 2016,60 patients with nonunion were treated,including 41 males and 19 females,aged 18 to 42 years old with an average age of 29 years old. Patients with nonunion were divided into autologous bone transplantation treatment group(control group),autologous bone transplantation and platelet-rich plasma(PRP) combined with extracorporeal shock wave(ESW) treatment group(experimental group). The callus formation,local complications,final growth of fracture and Johner-Wruhs functional classification of operative limbs of the two groups were compared 3 months after operation.
Results:Fifty-five patients were followed up,27 in the control group and 28 in the experimental group,5 patients were lost. The follow-up period ranged from 8 to 24 months. The callus score in the control group was significantly lower than that in the experimental group at 3 months after operation(P<0.05). There was no swelling and infection in the skin of the iliac bone acquisition site and non-union operation site in both groups. The clinical and bone healing time of the control group was significantly longer than that of the experimental group(P<0.05). In the experimental group,28 patients achieved bone union; in the control group,24 patients achieved bone union,and 3 patients had bone nonunion again. The excellent and good rate of Johner-Wruhs functional classification of affected limbs in the control group was significantly lower than that in the experimental group(P<0.05).
Conclusion:Autologous iliac bone transplantation combined with platelet-enriched plasma(PRP) and extracorporeal shock wave(ESW) has a certain effect in the treatment of bone nonunion after fracture surgery. It can significantly improve the formation of new bone. It is a comprehensive and useful way to treat bone nonunion after fracture surgery in clinical work. |
| KEY WORDS Fractures,ununited Bone transplantation Platelet-rich Plasma Extracorporeal shockwave therapy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 储伟.复合富血小板血浆的自体骨移植联合体外冲击波治疗骨不连[J].中国骨伤,2019,32(5):434~439 |
| 英文格式: | CHU Wei.Treatment of nonunion with autologous bone transplantation combined with platelet-rich plasma and extracorporeal shock wave[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(5):434~439 |
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