背景:对于骨肿瘤性骨缺损,以往多采用取自体髂骨移植修复。目的:以自体髂骨移植修复骨肿瘤或瘤样病变引起的腔洞性骨缺损为对照标准,观察脱蛋白牛松质骨结合自体红骨髓移植封闭残腔以及新生骨密度的情况。设计:随机分组设计、对照观察。单位:解放军第一七五医院骨科。对象:选择1993-07/1998-07解放军第一七五医院骨科收治骨缺损患者125例。随机分为实验组63例,患病时间(6.2±2.1)个月,骨缺损(136±30)mm3。对照组62例,患病时间(6.1±2.3)个月,骨缺损(133±37)mm3。方法:实验组接受脱蛋白牛松质骨结合自体红骨髓移植治疗,对照组接受自体髂骨移植治疗。首先彻底刮除肿瘤组织,用体积分数为0.95的乙醇烧灼创面后,再刮除烧灼面致出血,然后植入骨移植材料,植入的骨量要充足、紧密。以术后第1周的X射线片作为新骨生长的密度对比标准,术后第3,6,8个月分别摄X射线片,以术后8个月指标为两组比较标准。主要观察指标:比较骨缺损愈合情况,以残腔封闭及新生骨密度为标准。结果:两组患者平均随访20个月。随访6个月时,实验组失访1例。随访18个月时实验组和对照组各失访2例。术后8个月两组患者的骨折愈合情况:骨缺损残腔消失,新骨组织与母骨融合为一体,密度和正常骨相同或高于正常骨,实验组44例,对照组46例;骨残腔基本消失,新生骨密度接近于正常骨,实验组12例,对照组10例。与自体骨移植材料相比,脱蛋白牛松质骨与自体红骨髓结合后对修复腔洞性骨缺损疗效相当。结论:应用脱蛋白牛松质骨结合自体红骨髓移植与自体骨移植修复腔洞性骨缺损,均可使腔洞性骨缺损残腔基本消失,新生骨密度接近正常骨,两种方法疗效相当。 BACKGROUND: In the past, bone tumors were repaired with bone grafts. OBJECTIVE: To compare the densities of deproteinated bovine cancellous bone combined with autologous red bone marrow transplantation to remnant cavity and the density of new bone with the use of autologous tibial bone graft to repair the cavity bone defects caused by bone tumors or tumor-like lesions. Design: random grouping design, control observation. Unit: Department of Orthopaedics, 175th Hospital of PLA. PARTICIPANTS: One hundred and twenty-five patients with osseous defects admitted to the Department of Orthopaedics at the 175th Hospital of the Chinese People’s Liberation Army (PLA) from 1993 to 1998 were selected. Randomly divided into experimental group of 63 patients, the time of illness (6.2 ± 2.1) months, bone defect (136 ± 30) mm3. In the control group, there were 62 cases (6.1±2.3 months) and bone defect (133±37) mm3. Methods: The experimental group received deproteinated bovine cancellous bone combined with autologous red bone marrow transplantation. The control group received autologous iliac bone graft. Firstly, the tumor tissue was completely scraped off. After the wound was burned with ethanol having a volume fraction of 0.95, the bleeding on the cautery surface was scraped off. Then the bone graft material was implanted. The amount of implanted bone was sufficient and tight. X-ray film was taken as the new bone growth density contrast standard at the first postoperative week. X-ray films were taken at the 3rd, 6th, and 8th months after surgery. MAIN OUTCOME MEASURES: The healing of bone defect was compared, and the residual cavity was closed and the new bone density was the standard. Results: The two groups were followed for an average of 20 months. At the follow-up period of 6 months, the experimental group lost one case. At the follow-up of 18 months, the experimental group and the control group lost 2 cases each. At 8 months postoperatively, the fracture healing of the two groups was as follows: the residual cavity of the bone defect disappeared, the new bone tissue was fused with the mother bone, and the density was the same as or higher than that of the normal bone. There were 44 cases in the experimental group and 46 cases in the control group. The residual cavity of the bone disappeared, and the new bone density was close to that of the normal bone. There were 12 cases in the experimental group and 10 cases in the control group. Compared with autologous bone graft materials, the combination of deproteinated bovine cancellous bone and autologous red bone marrow has the same effect on the repair of cavity bone defects. CONCLUSION: The application of deproteinated bovine cancellous bone combined with autologous red bone marrow transplantation and autogenous bone graft in the repair of cavity bone defects can make the residual cavity of the cavity bone defect disappear, and the new bone density approaches normal bone. .