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1、中國修復(fù)重建外科雜志2000年第14卷第6期·365·?組織工程?組織工程肋骨移植修復(fù)胸壁巨大缺損121121楊志明趙雍凡解慧琪黃富國劉欣李濤【摘要】目的應(yīng)用組織工程技術(shù)構(gòu)建的肋骨和帶蒂皮瓣移位修復(fù)1例25歲女性患者胸壁巨大韌帶樣纖維瘤切除后,合并軟組織、肋骨缺損的早期效果。方法經(jīng)髂骨穿刺抽取骨髓組織,按Houghton法分離培養(yǎng)骨髓基質(zhì)干細(xì)胞,經(jīng)定向誘導(dǎo)分化為成骨樣細(xì)胞;用同種異體肋骨經(jīng)去細(xì)胞、去抗原、部分脫鈣和凍干處理,制成保存天然6框架的生物衍生骨支架,將5×10?ml骨髓基質(zhì)干細(xì)胞與骨支架
2、材料聯(lián)合培養(yǎng)6天;待完整切除腫瘤后,用膈肌瓣修復(fù)胸膜腔,組織工程肋骨修復(fù)3根肋骨,同側(cè)帶蒂側(cè)腹壁皮瓣移位修復(fù)胸壁軟組織缺損。結(jié)果手術(shù)經(jīng)過順利,傷口é期愈合。術(shù)后3個月隨訪,植入組織工程肋骨在體內(nèi)逐漸發(fā)育成成熟肋骨,心肺功能顯著改善。結(jié)論應(yīng)用自體骨髓基質(zhì)干細(xì)胞構(gòu)建的組織工程肋骨在個體化治療中顯示了優(yōu)越性?！娟P(guān)鍵詞】組織工程肋骨胸壁腫瘤骨髓基質(zhì)干細(xì)胞HUGETHORACICWALLDEFECTREPAIREDBYTISSUEENGINEEREDBONETRANSPLANTATION?YANGZhi2m
3、ing,ZHAOYong2fan,XIEHui2qi,etal.DepartmentofOrthopedicSurgery,theFirstUniversityHospital,WestChinaUniversityofMedicalSciences,ChengduSichuan,P.R.China610041.E2mail:orthop@public.cd.sc.cn【Abstract】ObjectiveArarehugedesmoplasticfibromaonthoracicwallin1f
4、emalecaseof25yearsoldwasresected,andtheaccompanyinghugethoracicwalldefect,ribsandsofttissueswererepairedbytissueengi2neeredboneandpedicledflap.Thepaperaimstoexploretheclinicalresultsofearlystageafteroperation.MethodsAutogeneicbonemarrowstromalcells(MS
5、C)wereobtainedfrombonemarrowpunctureofiliacboneandisolatedandculturedaccordingtotheHoughton'smethods,MSCweredirectivelyinducedanddifferentiatedtoosteoblasts.Allogeneicribsweremadetothebio2derivedbonescaffoldmaterialsaftertreatmentofdecell,deantigen,de
6、calcifi26cationanddryfreezing.5×10?mlMSCwerecoculturedwiththebio2derivedbonefor6daysinvitro.Afterintactresectionoftumor,thediaphragmflapwasappliedtorepairpleuralcavity,thethreedefectribswererepairedbytissueengineeredboneandthesofttissuedefectwasrepair
7、edbytransferofpedicledipsilateralabdominalflaps.ResultsThepatientrecoveredwellwithfirstintention.Followedupfor3months,tissueengineeredribswerematuredinvitroandtheheartandpulmonaryfunctionswereimprovedmarkedly.ConclusionThetissueengi2neeredboneconstruc
8、tedbyautogeneicMSCisadvantageousinindividualtreatment.【Keywords】TissueengineeringRibTumorofthoracicwallBonemarrowstromalcellsFoundationitems:NationalBasicScienceResearchandDevelopmentGrants(G1999054308);NationalNatu2ralScienceFoundationofChina
