锁定接骨板联合同种异体骨治疗四肢长骨良性骨肿瘤伴病理性骨折的60例疗效分析

摘要

目的 探讨锁定接骨板联合同种异体骨治疗四肢长骨良性骨肿瘤伴病理性骨折的的疗效.方法 选取了60例良性骨肿瘤患者,按住院单双号随机分为两组,研究组(31例)行锁定接骨板联合同种异体骨,对照组(29例)行锁定接骨板.观察并记录患者术后12个月的患肢功能,血清骨折愈合相关因子,VAS评分,2年内的排斥反应率,病灶复发率和骨折愈合时间,以评价两种手术方式的疗效.结果 术后12个月,研究组优良率明显高于对照组(P<0.05),随访2年期间,研究组排斥反应率、骨折愈合时间、病灶复发率均少于或低于对照组(P<0.05);术后12个月,两组骨钙素(BGP)、骨保护素(OPG)、碱性磷酸酶(ALP)、神经生长因子(NGF)水平均明显升高(P<0.05),且研究组上述指标明显高于对照组(P<0.05);术后6,12个月,两组痛觉感受评分均明显降低(P<0.05),但组间比较差异无统计学意义(P>0.05).结论 锁定接骨板联合同种异体骨对四肢长骨良性骨肿瘤伴病理性骨折具有较好的治疗效果,术后提高患肢功能,减轻疼痛,促进骨折愈合,降低肿瘤复发率,值得临床推广使用.%Objective To study the efficacy of locking plate combined with allograft bone for 60 cases long bone of be-nign bone tumor with pathological fracture .Methods 60 patients with long bone of benign bone tumor and pathological fracture were selected ,they were divided into 2 groups according to the odd-even number of hospitalization .The study group ( 31 cases ) was given locking plate combined with allograft bone .The control group(29 cases) was only given locking plate .The efficacy of locking plate combined with allograft bone for 60 cases long bone of benign bone tumor with pathological fracture was evaluated by limb function,serum bone fracture healing related factor ,VAS score,rejection rate,recurrence rate and fracture healing time .Re-sults The excellent and good rate of the study group was significantly higher than that of the control group (P<0.05).During 2 years of follow-up,the rejection rate ,recurrence rate and fracture healing time of the study group was less or shorter than that of the control group(P<0.05).After 12 months surgery,the BGP,OPG,ALP and NGF levels of the 2 groups increased (P <0.05).These indexes of the study group were significantly higher than that of the control group (P <0.05).After 6 and 12 months surgery,VAS scores of the 2 groups decreased(P<0.05).But there were no statistical difference in VAS scores between the 2 groups(P>0.05).Conclusion The locking plate combined with allograft bone has a good therapeutic effect on long bone of benign bone tumors and pathological fractures .It could improve the function of affected limb , relieve pain , promote fracture healing,reduce the recurrence rate of tumor .It is worthy of clinical use .