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1、中国修复重建外科杂志2000年第14卷第6期·365·õ组织工程õ组织工程肋骨移植修复胸壁巨大缺损121121杨志明赵雍凡解慧琪黄富国刘欣李涛【摘要】目的应用组织工程技术构建的肋骨和带蒂皮瓣移位修复1例25岁女性患者胸壁巨大韧带样纤维瘤切除后,合并软组织、肋骨缺损的早期效果。方法经髂骨穿刺抽取骨髓组织,按Houghton法分离培养骨髓基质干细胞,经定向诱导分化为成骨样细胞;用同种异体肋骨经去细胞、去抗原、部分脱钙和冻干处理,制成保存天然6框架的生物衍生骨支架,将5×10öml骨髓基质干细胞与骨支架
2、材料联合培养6天;待完整切除肿瘤后,用膈肌瓣修复胸膜腔,组织工程肋骨修复3根肋骨,同侧带蒂侧腹壁皮瓣移位修复胸壁软组织缺损。结果手术经过顺利,伤口É期愈合。术后3个月随访,植入组织工程肋骨在体内逐渐发育成成熟肋骨,心肺功能显著改善。结论应用自体骨髓基质干细胞构建的组织工程肋骨在个体化治疗中显示了优越性。【关键词】组织工程肋骨胸壁肿瘤骨髓基质干细胞HUGETHORACICWALLDEFECTREPAIREDBYTISSUEENGINEEREDBONETRANSPLANTATIONöYANGZhi2m
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.5×10ömlMSCwerecoculturedwiththebio2derivedbonefor6daysinvitro.Afterintactresectionoftumor,thediaphragmflapwasappliedtorepairpleuralcavity,thethreedefectribswererepairedbytissueengineeredboneandthesofttissuedefectwasrepair
7、edbytransferofpedicledipsilateralabdominalflaps.ResultsThepatientrecoveredwellwithfirstintention.Followedupfor3months,tissueengineeredribswerematuredinvitroandtheheartandpulmonaryfunctionswereimprovedmarkedly.ConclusionThetissueengi2neeredboneconstruc
8、tedbyautogeneicMSCisadvantageousinindividualtreatment.【Keywords】TissueengineeringRibTumorofthoracicwallBonemarrowstromalcellsFoundationitems:NationalBasicScienceResearchandDevelopmentGrants(G1999054308);NationalNatu2ralScienceFoundationofChina
