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目的研究新型骨替代材料纳米晶羟基磷灰石和胶原的复合材料(NHAC)修复骨缺损的临床疗效。方法9例骨缺损的患儿接受纳米晶羟基磷灰石和胶原的复合材料移植治疗,其中男8例,女1例;年龄4~13岁,平均10岁。所有患儿局部骨缺损处植入NHAC,其中颅骨骨缺损处植入薄片状NHAC,枕骨所致的6.0cm×6.0cm大面积的骨缺损植入咬除的部分自体颅骨和NHAC;颞骨因开颅手术后留下4个2.0cm×1.0cm小面积骨缺损,我们每个病例选左侧的植入NHAC,右侧不植入任何材料作为对照组。掌骨部位植入块状NHAC。平均随访1年,观察植骨部位骨愈合情况。结果除1例患儿术后接受放疗植骨失败,其他所有患儿术后局部无跟植入NHAC材料有关的并发症出现,无感染,切口均Ⅰ期愈合。枕骨大面积缺损的患儿于1年后骨缺损全部愈合;颞骨小面积缺损的患儿不同时间段里骨愈合明显,而对照组骨缺损区仍表现为低密度影;掌骨骨缺损3个月也达到了骨愈合。结论NHAC是临床治疗骨缺损理想而有效的骨替代材料。
Objective To study the clinical efficacy of novel bone substitute nanocomposite materials hydroxyapatite and collagen composite (NHAC) in repairing bone defects. Methods Nine children with bone defect underwent composite grafts of hydroxyapatite and collagen nanocomposite. There were 8 males and 1 females, aged from 4 to 13 years with an average of 10 years. All pediatric local bone defects were implanted with NHAC, in which skull defects were implanted with laminar NHAC. A large 6.0cm × 6.0cm bone defect caused by the occipital bone was implanted into part of autologous craniocervical bone and NHAC. The temporal bone was opened After craniotomy left four 2.0cm × 1.0cm small area of bone defects, each case we selected NHAC implanted on the left, the right is not implanted any material as a control group. Metacarpal site implanted massive NHAC. After a mean follow-up of 1 year, bone healing was observed. Results All patients except one had failed to receive radiotherapy and bone grafting after operation, and all the other complications were not associated with the implantation of NHAC after operation. No infection occurred and the incisions healed in the first stage. Children with a large defect of the occipital bone healed completely after 1 year. Children with small temporal bone defect had obvious bone healing at different time points, while the control group showed low density shadow at 3 days Bone healing has also been achieved. Conclusion NHAC is an ideal and effective bone substitute for clinical treatment of bone defects.