摘要
背景:扩髓-灌洗-吸引器所取骨量较多,还含有较多基质干细胞和多种成骨因子,故可用来作为获取大量自体骨移植方法。目的:介绍扩髓-灌洗-吸引器的应用研究和进展。方法:由第一作者检索Pub Med数据库(2000年1月至2017年5月)有关扩髓-灌洗-吸引器的文献,以"Reamer-irrigator-aspirator"为检索词,共查阅文献87篇,其中38篇符合纳入标准。结果与结论:与髂骨取骨相比,利用高速钻头扩髓器可获取更多数量的自体骨和骨髓基质干细胞,其成骨效果不亚于髂骨,而并发症更少,作为非结构性自体骨移植的一种方法得到较为广泛应用。利用高速钻头扩髓器清除髓腔内病变,用于治疗长骨骨感染、骨髓炎和骨肿瘤,以及用于清除髓腔骨水泥。高速钻头扩髓最初作为股骨干骨折髓内钉固定特殊扩髓方法,具有降压和降温作用,减少扩髓高压致脂肪栓塞和高温致骨热坏死风险。总体上,高速钻头扩髓并发症较少,治疗效果满意,但也存在费用大、透视较多、出血多、适应证有限和医源性骨折或穿孔等风险。
BACKGROUND： Large volume of bone can be harvested by the reamer-irrigation-aspirator（RIA）, which can be used for autologous bone graft, because there are many stromal stem cells and a variety of osteogenesis factors in the harvested bone. OBJECTIVE： To introduce the application progress of the RIA. METHODS： Pub Med database was retrieved by the first author for RIA-related articles published from January 2000 to May 2017 using the keyword of ＂reamer-irrigator-aspirator＂. A total of 87 articles were searched initially and finally 38 articles met the inclusion criteria. RESULTS AND CONCLUSION： Compared with harvesting bone tissues from the iliac bone, the RIA can harvest more autologous bone tissues with more bone marrow stromal stem cells. Moreover, the osteogenic effect of the harvested autologous bone is better and there are fewer complications. Therefore, the RIA has been widely usedas a method of harvesting non-structural autologous bone tissues. Removal of intramedullary lesions by the RIA is used in the treatment of long bone infection, osteomyelitis and bone tumors, as well as in the removal of intramedullary cement. RIA was originally used as a special reaming during intramedullary nailing for femoral shaft fractures, which could reduce high pressure and high temperature so as to decrease the risks of fat embolism and osteonecrosis. To conclude, the RIA can achieve satisfactory outcomes and result in few complications, but the clinical use is still limited by high cost, frequent fluoroscopy, bleeding and limited indications, as well as risks for iatrogenic fractures and perforation.
作者
李海峰
顾三军
殷渠东
Li Hai-feng;Gu San-jun;Yin Qu-dong(Department of Orthopaedics, the Ninth People＇s Hospital of Wuxi, Wuxi 214062, Jiangsu Province, China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第14期2284-2289,共6页
Chinese Journal of Tissue Engineering Research
