骨搬移术联合对合端植骨内固定术治疗下肢大段骨缺损的效果及对血清bFGF、PDGF、VEGF、TGF-β表达的影响

doi:10.3969/j.issn.1007-3205.2020.11.006

摘要/Abstract

摘要： 目的探究骨搬移术联合对合端植骨内固定术治疗下肢大段骨缺损的效果及对血清碱性成纤维细胞生长因子（basic fibroblast growth factor，bFGF）、血小板衍生生长因子（platelet derived growth factor，PDGF）、血管内皮生长因子（vascular endothelial growth factor，VEGF）、转化生长因子β（transforming growth factor-β,TGF-β）表达的影响。
方法选取进行手术治疗的下肢大段骨缺损患者50例，采用随机数字表法分为单一组（25例）及联合组（25例）。单一组使用骨搬移术治疗，联合组在单一组基础上加用对合端植骨内固定术治疗。比较2组愈合情况、并发症发生率、对合端接触后即刻与接触后1周血清炎性因子［C反应蛋白（C-reactive protein，CRP）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）及核因子κB（nuclear factor kappa-B，NF-κB）］、bFGF、PDGF、VEGF、TGF-β表达情况。
结果联合组骨愈合指数、骨愈合时间、外固定时间低于或短于单一组，骨愈合优良率显著高于单一组（P＜0.05）；对合端接触后即刻，2组CRP、TNF-α、NF-κB、bFGF、PDGF、VEGF、TGF-β水平差异无统计学意义（P＞0.05）；接触后1周，2组血清CRP、〖JP2〗TNF-α、NF-κB水平均低于接触后即刻，联合组bFGF、PDGF、VEGF、TGF-β〖JP〗水平显著高于接触后即刻，联合组血清CRP、TNF-α、NF-κB水平显著低于单一组，bFGF、PDGF、VEGF、TGF-β水平显著高于单一组（P＜0.05）。联合组骨对合端不愈合、钉道感染、固定物松动、关节挛缩、下肢力线不良发生率显著低于单一组（P＜0.05）。
结论骨搬移术联合对合端植骨内固定术治疗下肢大段骨缺损能有效缩短骨愈合时间，改善骨愈合情况，降低炎症反应，升高骨再生相关因子，减少并发症发生率，具有临床推广意义。

关键词: 骨折固定术, 骨搬移术, 骨折愈合

Abstract: Objective To explore the effect of bone transfer combined with joint bone grafting and internal fixation in the treatment of large bone defects of the lower extremities and the serum basic fibroblast growth factor(bFGF) and platelet-derived growth factor platelet derived growth factor(PDGF), vascular endothelial growth factor(VEGF), transforming growth factor β(TGF-β) expression.
Methods Fifty patients with large-segment bone defects of the lower limbs were selected for surgical treatment, and they were divided into a single group(25 cases) and a combined group(25 cases) using a random number table method. The single group was treated with bone transfer, and the combined group was treated with contralateral bone grafting and internal fixation on the basis of the single group. Comparing the healing status, complication rate, and serum inflammatory factors ［C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α) and nuclear factor kappa-B(NF-κB)］, bFGF, PDGF, VEGF, TGF-β, immediately after contact with the opposite ends and 1 week after contact between the two groups expression.
Results The complication rate of bone healing index, bone healing time, external fixation time, nonunion of bone commissure, and nail infection was significantly lower than that of the single group. The excellent rate of bone healing was significantly higher than that of the single group(P＜0.05); Immediately after exposure to the end, the levels of CRP, TNF-α, NF-κB and bFGF, PDGF, VEGF, TGF-β were not significantly different(P＞0.05), 1 week after exposure, combined group CRP, the levels of TNF-α and NF-κB were significantly lower than those of the single group, and the levels of bFGF, PDGF, VEGF and TGF-β were significantly higher than those of the single group(P＜0.05).
Conclusion Bone transfer combined with end-to-end bone grafting for the treatment of large segmental bone defects can effectively shorten the bone healing time, improve the bone healing, reduce the inflammatory response and increase the level of bone regeneration related factors, and reduce the patients. Complications have clinical significance.

Key words: fracture fixation, bone transfer, fracutre healing

万伦, 刘类高, 朱定川, 高峰. 骨搬移术联合对合端植骨内固定术治疗下肢大段骨缺损的效果及对血清bFGF、PDGF、VEGF、TGF-β表达的影响[J]. 河北医科大学学报, 2020, 41(11): 1266-1270.

WAN Lun, LIU Lei-gao, ZHU Ding-chuan, GAO Feng. Effect of bone transfer combined with end-to-end bone grafting on the treatment of large segmental bone defects of lower extremity and its effect on the expression of serum bFGF, PDGF, VEGF and TGF-β[J]. Journal of Hebei Medical University, 2020, 41(11): 1266-1270.

[1]	张林, 陈晓钢, 季沐梵, 丁静, 刘青柏. 术前椎体压缩程度联合骨密度对胸腰椎骨折椎弓根螺钉内固定术后椎体高度再丢失的预测 [J]. 河北医科大学学报, 2023, 44(3): 274-278.
[2]	磨焕鹏, 胡东辉, 邓妙芳, 张亚忠, 何晖. 经皮交叉克氏针内固定治疗儿童Gartland Ⅲ型肱骨髁上骨折的疗效 [J]. 河北医科大学学报, 2023, 44(2): 184-188,235.
[3]	张清林, 荣存敏, 陈磊, 张光辉, 栗威, 张磊. 经跗骨窦入路复位钢板固定、L形切口复位内固定治疗跟骨骨折的临床应用比较 [J]. 河北医科大学学报, 2023, 44(1): 62-67.
[4]	闫天元, 张国辉, 李华. 关节镜下闭合复位经皮内固定对踝关节骨折术后AOFAS评分、骨代谢标志物及创伤反应的影响[J]. 河北医科大学学报, 2022, 43(5): 550-555.
[5]	陈宇峰（综述）, 任栋, 王鹏程（审校）. Pauwels Ⅲ型股骨颈骨折内固定选择策略的研究进展[J]. 河北医科大学学报, 2022, 43(1): 108-113.
[6]	陈宇峰, 任栋, 姚双权, 耿林丹, 盛凯, 王鹏程. 特制加压器在旋转支撑接骨板治疗胫骨后外侧平台骨折中的初步应用[J]. 河北医科大学学报, 2021, 42(5): 606-608.
[7]	李运进，黄平，黄东永，张燕青，叶小燕. 肘关节复杂骨折中动力型外固定支架的应用效果及随访分析[J]. 河北医科大学学报, 2020, 41(2): 149-153.
[8]	章伟，高田田，蔡韵律，孙平*，付士平. 闭合复位髓内钉内固定治疗老年肱骨外科颈骨折临床观察[J]. 河北医科大学学报, 2019, 40(10): 1149-1153.
[9]	刘〓欢（综述），郑占乐*，张英泽（审校）. 骨盆骨折内固定的生物力学进展#br#[J]. 河北医科大学学报, 2018, 38(7): 857-860.
[10]	王〓伟，李〓升，刘建宁，徐国辉，郭跻超，齐向北*. 应用特殊复位器辅助复位髓内钉固定治疗多节段股骨干骨折临床研究[J]. 河北医科大学学报, 2018, 38(4): 413-415,430.
[11]	张瑞鹏,李石伦,尹英超,陈〓伟,侯志勇,张英泽*. 腓骨截骨+胫骨高位截骨四点支撑钢板撑开固定治疗重度骨性膝关节炎[J]. 河北医科大学学报, 2018, 38(10): 1224-1226.
[12]	王保宁1，周彦青1，杨双贵1，王〓静2. 微创钢板辅助加压螺钉对跟骨关节内骨折患者术后恢复效果及并发症的影响[J]. 河北医科大学学报, 2017, 37(7): 832-834.
[13]	蒲晓鹏1，许〓可1，任〓强1，邢〓蕾2，李西成1*. 股骨近端防旋髓内钉螺旋刀片置入辅助定位器的临床应用[J]. 河北医科大学学报, 2017, 37(10): 1153-1157.
[14]	郑占乐,常恒瑞,孟德飞,李升,张英泽*. 胫骨平台骨折合并腓骨近端骨折的相关研究[J]. 河北医科大学学报, 2016, 37(6): 722-724.
[15]	张华良,靳云乔,何海潮. 磁力导航中空带锁髓内针治疗下肢管状骨骨折的临床疗效评价[J]. 河北医科大学学报, 2016, 37(3): 321-324.

骨搬移术联合对合端植骨内固定术治疗下肢大段骨缺损的效果及对血清bFGF、PDGF、VEGF、TGF-β表达的影响

Effect of bone transfer combined with end-to-end bone grafting on the treatment of large segmental bone defects of lower extremity and its effect on the expression of serum bFGF, PDGF, VEGF and TGF-β

HTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价