论文部分内容阅读
目的探讨肢体骨复发性骨巨细胞瘤的治疗方法及疗效。方法 2001年10月-2008年7月共收治肢体骨复发性骨巨细胞瘤23例,男14例,女9例。年龄19～52岁,平均32.2岁。股骨远端9例,胫骨近端5例,桡骨远端4例,肱骨近端3例,股骨近端2例。复发时间为术后7个月-6年4个月,平均25.7个月。根据发病部位、放射线分级选择的治疗方法为:再次刮除+骨水泥充填15例,瘤段切除+人工假体重建6例,自体腓骨重建2例。结果随访时间10个月至6年6个月,平均37.6个月。再次刮除组中2例复发(13-3%),瘤段切除组无局部复发,根据Eneeking评分标准,瘤段切除+功能重建组的肢体功能优良率达75.3%。结论囊内刮除虽仍存在再次复发的风险,但可较完好的保留关节功能,应作为治疗的首选。对Companacci Ⅲ级的肢体骨复发性骨巨细胞瘤采用瘤段切除与功能重建治疗可有效地降低局部复发率,近期疗效满意。
Objective To investigate the treatment and efficacy of limb bone recurrent giant cell tumor of bone. Methods Twenty-three patients with bone-recurrent giant cell tumor of bone were treated in October 2001-July 2008, including 14 males and 9 females. Age 19 ~ 52 years old, average 32.2 years old. There were 9 cases of distal femur, 5 cases of proximal tibia, 4 cases of distal radius, 3 cases of proximal humerus and 2 cases of proximal femur. The recurrence time was 7 months after operation - 6 years and 4 months, an average of 25.7 months. According to the site of the disease, radiation therapy for the classification of choice: curettage + bone cement filling in 15 cases, tumor resection + artificial prosthesis reconstruction in 6 cases, autologous fibular reconstruction in 2 cases. Results The follow-up time ranged from 10 months to 6 years and 6 months with an average of 37.6 months. According to Eneeking score, the excellent and good rate of limb function was 75.3% in tumor resection plus functional reconstruction group in two resection group (13-3%). Conclusion Although cystic curettage is still at risk of recurrence, but can retain the joint function better, should be used as the treatment of choice. Companacci grade Ⅲ limb bone recalcitrant giant cell tumor with tumor resection and functional reconstruction of the treatment can effectively reduce the local recurrence rate, the recent satisfactory results.