桂忠山,宁显宗,朱亮亮,王桂华,周斌,王北岳

• 1:南京市浦口人民医院骨科

摘要(Abstract)：

[目的]探讨影响Masquelet重建手术中诱导膜血管形成的相关因素。[方法] 2019年8月—2021年10月采用Masquelet技术治疗的36例骨缺损患者纳入本研究，观察诱导膜组织血管形成和分布情况，采用单因素比较和多因素分析探讨影响诱导膜血管形成的相关因素。[结果]36例患者均顺利完成一期手术，二期手术取诱导膜组织切片血管计数，根据诱导膜组织切片血管计数的中位数将患者分为两组，中位数之上纳入良好组，中位数之下纳入不足组，两组各18例。单项因素比较表明：良好组患者组织学评估中的膜内成骨数量[例,有/无,(4/14) vs(0/18), P=0.021]显著高于不足组，伤口闭合使用游离皮瓣数量[例,行游离皮瓣/未行游离皮瓣,(2/16) vs(7/11), P=0.029]显著低于不足组，诱导膜血管计数[条/mm~2,(53.4±12.7) vs(21.4±7.1), P<0.001]显著多于不足组。两组炎症反应、异物反应、纤维化分级、骨缺损部位、原因、长度，肌肉覆盖情况、清创程度、填充骨水泥情况、一期术后切口愈合等级、骨水泥放置时间或二次手术间隔时间的比较差异均无统计学意义（P>0.05）。多因素分析结果显示，伤口闭合使用游离皮瓣、诱导膜有膜内成骨是影响诱导膜内血管数量的相关因素，其标准化偏回归系数分别为-0.350、0.384。[结论]年龄、性别、BMI、吸烟、饮酒、糖尿病及大部分骨缺损相关资料对诱导膜血管化无影响。诱导膜有膜内成骨、伤口闭合使用游离皮瓣是影响诱导膜内血管数量的相关因素。

关键词(KeyWords)： Masquelet技术;诱导膜;骨缺损;血管分布;组织学分析

Abstract:

Keywords:

基金项目(Foundation): 南京市卫生科技发展专项资金项目（编号：YKK18228）

作者(Author): 桂忠山,宁显宗,朱亮亮,王桂华,周斌,王北岳

DOI: 10.20184/j.cnki.Issn1005-8478.110534

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