中文摘要：

目的探讨自体富血小板血浆（platelet-rich plasma，PRP）联合骨搬移技术在治疗胫骨缺损方面的有效性及安全性。方法采用前瞻性随机对照单盲的方法，选取2013年1月至2015年3月因创伤、感染因素造成的胫骨骨缺损的28例患者，采用随机数表加密闭信封方法将全部患者随机分为两组，其中PRP联合骨搬移组（简称PRP组）15例及单纯骨搬移组13例。PRP组15例，男12例，女3例；平均年龄40．9岁；平均骨缺损长度7．1cm；创伤性6例，感染性9例。骨搬移组13例，男10例，女3例；平均年龄37．7岁；平均骨缺损长度6．5cm；创伤性3例，感染性10例。采用Ilizarov方法研究与应用学会（Association of the Study and Application of the Method of Ilizarov，ASAMI）分类评价骨愈合及下肢功能情况，并记录两组外固定支架指数（患者佩戴外固定支架的时间除以骨搬移长度或骨延长长度）、并发症及术后疼痛情况[采用视觉模拟评分（visual analogue scale，VAS）进行评价]等。结果PRP组和骨搬移组的平均随访时间分别为21．8个月和23．2个月。PRP组15例骨缺损均愈合，愈合时间为平均183．2d；骨搬移组13例患者中，11例骨缺损愈合，愈合时间平均218．6d，2例骨缺损未愈合，经再次手术打通髓腔，植骨后愈合。术后疼痛VAS评分：术后第1天，PRP组（3．33±2．58）分，骨搬移组（4．46±2．73）分；第7天，PRP组（2．67±2．09）分，骨搬移组（3．00±2．20）分；术后两周，PRP组（1．46±1．77）分，骨搬移组（2．62±2．72）分；各时间点两组比较差异均无统计学意义。两组外固定支架指数，PRP组为（37．9±7．7）d／cm，骨搬移组为（46．9±13．7）d／cm，两组比较差异有统计学意义。按照ASAMI评价骨折愈合情况，PRP组9例评价为优，5例为良，优良率为93．3％（14／15）；骨搬移组7例评价为优，3例为良，优良率为76．9?

英文摘要：

Objective To investigate the effect of autologous platelet rich plasma along with bone transportation in tibia defect. Methods This was a randomized single-blind placebo controlled clinical trial. From Jan 2013 to Mar 2015, 28 patients （28 cases） suffering from tibia defect because of trauma or osteomyelitis were randomly assigned to PRP group （PRP along with bone transportation, n= 15） or bone transportation group （bone transportation only, n= 13） through random number table and sealed envelop method. PRP group： male to female 12： 3, average age： 40.9 years old, average bone defect： 7.1 cm, 6 caused by trauma, 9 by osteomyelitis; while bone transportation group： male to female 10：3, average age： 37.7 years old, average bone defect： 6.5 cm, 3 caused by trauma and 10 by osteomyelitis. Bony results and tibia function were evaluated according to the Association of the Study and Application of the Method of Ilizarov （ASAMI）protocol. The external fixation index, complications and VAS pain score were also evaluated. Results The mean follow-up time was 21.8 m in PRP group and 23.2 m in bone transportation group and there were no loss to follow-up. There were no differences between two groups on postoperative VAS pain score： 1st d postoperative （3.33±2.58 vs 4.46±2.73）; 7th d postoperative （2.67±2.09 vs 3.00±2.20）; and 2 weeks postoperative （1.46±1.77 vs 2.62±2.72）. There was significant difference between two groups on external fixation index （37.9±7.7 d/cm vs 46.9±13.7 d/cm）. According to the ASAMI protocol, all patients achieve bone union, except 2 cases in control group which need revision surgery; excellent and good rate of bone defect union was 93% in PRP group while 77% in control group; while no difference was found on complication and lower extremity function. Conclusion Application of PRP along with bone transportation in the treatment of tibia defect results in shorter healing duration and external fixation duration. But no short-term postoperative anal