关键词: 富血小板血浆, 同种异体骨植骨, 良性骨肿瘤, 病理性骨折

Abstract: Objective To investigate the clinical efficacy of Platelet-rich Plasma(PRP) combined with allogeneic bone transplantation in the treatment of pathological fractures caused by benign bone tumors or tumor-like lesions.Methods Patients with pathological fractures caused by benign bone tumors or tumor-like lesions in the orthopedic department of our hospital from March 2018 to March 2021 were retrospectively analyzed.The operation time,intraoperative blood loss,hospital stay,clinical healing time,healing rate and postoperative X-ray callus score,serum inflammatory index,and the incidence of complications of group A(Patients who received PRP + allogeneic bone transplantation,n=21) and group B(Patients who received autologous bone transplantation,n=23) were observed and compared.The bone metabolism value and FMA score between the healthy side and the affected side at 1 month and 3 months after operation were compared.Results The operation time of the group B(132.65±20.84) min was shorter than that of group A(158.62±23.57) min and group C(156.79±23.36) min,and the intraoperative blood loss(475.84±68.33)ml was less than that of group A(525.00±73.82) ml and group C(528.39±74.72) ml(all P＜0.05).The clinical healing time of pathological fractures X-ray callus score at 3 months after operation,fracture healing rate at 1 year after operation and hospital stay had no significant differences in 3 groups(P＞0.05).The levels of serum CRP and IL-6 in 3 groups were increased on the 1st and 3rd day after the operation(all P＜0.05).The levels of serum CRP and IL-6 in the group A and C were higher than those of group B.In group A and B,2 patients had postoperative immune rejection,and 1 patient had postoperative incision redness and swelling.In group C,2 patients had persistent pain in the donor site after surgery,and 2 patients had incision redness and swelling.There was no significant difference in the total incidence of complications in 3 groupsP＞0.05).Compared with the groupA and C,the FMA value of group B increased significantly at 1 st and 3 rd month after operation(all P＜0.05). 3 months after operation,the bone metabolism value of the affected side was significantly increased(P＜0.05).Conclusion PRP combined with allogeneic bone transplantation in the treatment of pathological fractures caused by benign bone tumors or tumor-like lesions can shorten the operation time,reduce the amount of intraoperative blood loss and postoperative inflammatory reaction,and the bone healing effect is similar to that of autogenous bone transplantation,with less postoperative complications.

Key words: platelet-rich plasma, allogenic bone transplantation, benign bone tumor, pathological fracture