62例软骨母细胞瘤手术治疗分析
发布时间：2018-08-21 08:13
【摘要】：背景虽然软骨母细胞瘤是一种较少见的发生于骨骺的良性肿瘤,但其局部复发率较高,甚至发生远处转移,传统手术(主要是病灶刮除联合植骨或骨水泥)治疗后仍有一定复发率,术中辅助治疗可有效降低术后复发率,而传统手术联合术中辅助治疗软骨母细胞瘤的大样本研究少有报道。目的探讨传统手术联合术中辅助治疗软骨母细胞瘤的临床疗效。方法对2005年8月至2016年4月收治的62例软骨母细胞瘤病例的手术治疗进行回顾性分析,所有患者术前经详细的影像学评估后行传统手术联合术中辅助治疗。所有病例最终诊断以术后常规病理诊断为准。观察术后有无病灶复发、植骨愈合情况以及骨骺未闭合者的患肢长度。结果本组患者年龄最小9岁,最大48岁,平均19岁;男性48例,女性14例。病变位于股骨27例,胫骨19例,髌骨、肱骨、跟骨和髋臼各3例,距骨、跖骨、髂骨和肩胛骨各1例。随访时间为6个月到134个月,平均54个月。至随访结束时仅1例胫骨上段软骨母细胞瘤患者经肿瘤刮除灭活、植入、后交叉韧带止点重建术后17个月出现局部复发,再次刮除灭活,骨水泥填充手术治疗,至随访结束共5个月未见局部复发。本组局部复发率为1.6%,其他患者均未出现局部复发及远处转移。1例位于胫骨上段的软骨母细胞瘤患者术后日常活动时感轻度疼痛,膝关节活动范围无明显受限,能独立完成日常活动。其余患者无明显疼痛,日常工作及活动无明显受限。1例患者术后双下肢不等长,患肢短缩2cm,对活动无明显影响;其余患者术后无明显短缩,日常活动无影响。结论传统手术联合术中辅助治疗软骨母细胞瘤可取得良好的临床疗效。
[Abstract]:Background although chondroblastoma is a rare benign tumor in epiphysis, its local recurrence rate is high and even distant metastasis occurs. The recurrence rate of traditional surgery (mainly focus curettage combined with bone graft or bone cement) is still high, and adjuvant treatment during operation can effectively reduce the recurrence rate after operation. However, a large sample of conventional surgery combined with intraoperative adjuvant treatment of chondroblastoma is rarely reported. Objective to investigate the clinical effect of traditional surgery combined with intraoperative adjuvant treatment of chondroblastoma. Methods the surgical treatment of 62 cases of chondroblastoma from August 2005 to April 2016 was analyzed retrospectively. The final diagnosis of all cases was based on the postoperative routine pathological diagnosis. Postoperative recurrence, bone graft healing and limb length in patients with unclosed epiphysis were observed. Results the age of the patients was the youngest 9 years, the oldest 48 years, the average 19 years old, male 48 cases, female 14 cases. The lesions were located in 27 cases of femur, 19 cases of tibia, 3 cases of patella, humerus, 3 cases of calcaneus and acetabular, 1 case of talus, 1 case of metatarsal bone, 1 case of iliac bone and 1 case of scapular bone. The follow-up period ranged from 6 months to 134 months (mean 54 months). Up to the end of follow-up, only one case of chondroblastoma of the upper tibia was curettage and inactivated, implanted, local recurred 17 months after posterior cruciate ligament reconstruction, and was again curettage and inactivated, bone cement filling operation. No local recurrence was found at the end of follow-up for 5 months. The local recurrence rate was 1.6 in this group. None of the other patients had local recurrence or distant metastasis. 1 cases of chondroblastoma located in the upper tibia had mild pain in daily activities after operation, and the range of knee joint movement was not significantly limited. Be able to complete daily activities independently. There was no obvious pain in other patients, and there was no obvious limitation in daily work and activity. 1 cases had no significant effect on the activity of lower extremities and 2 cm contraction of the affected limbs, while the other patients had no obvious shortening and no effect on daily activities. Conclusion traditional surgery combined with intraoperative adjuvant treatment of chondroblastoma can obtain good clinical effect.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R738.3
，
本文编号：2195098
[Abstract]:Background although chondroblastoma is a rare benign tumor in epiphysis, its local recurrence rate is high and even distant metastasis occurs. The recurrence rate of traditional surgery (mainly focus curettage combined with bone graft or bone cement) is still high, and adjuvant treatment during operation can effectively reduce the recurrence rate after operation. However, a large sample of conventional surgery combined with intraoperative adjuvant treatment of chondroblastoma is rarely reported. Objective to investigate the clinical effect of traditional surgery combined with intraoperative adjuvant treatment of chondroblastoma. Methods the surgical treatment of 62 cases of chondroblastoma from August 2005 to April 2016 was analyzed retrospectively. The final diagnosis of all cases was based on the postoperative routine pathological diagnosis. Postoperative recurrence, bone graft healing and limb length in patients with unclosed epiphysis were observed. Results the age of the patients was the youngest 9 years, the oldest 48 years, the average 19 years old, male 48 cases, female 14 cases. The lesions were located in 27 cases of femur, 19 cases of tibia, 3 cases of patella, humerus, 3 cases of calcaneus and acetabular, 1 case of talus, 1 case of metatarsal bone, 1 case of iliac bone and 1 case of scapular bone. The follow-up period ranged from 6 months to 134 months (mean 54 months). Up to the end of follow-up, only one case of chondroblastoma of the upper tibia was curettage and inactivated, implanted, local recurred 17 months after posterior cruciate ligament reconstruction, and was again curettage and inactivated, bone cement filling operation. No local recurrence was found at the end of follow-up for 5 months. The local recurrence rate was 1.6 in this group. None of the other patients had local recurrence or distant metastasis. 1 cases of chondroblastoma located in the upper tibia had mild pain in daily activities after operation, and the range of knee joint movement was not significantly limited. Be able to complete daily activities independently. There was no obvious pain in other patients, and there was no obvious limitation in daily work and activity. 1 cases had no significant effect on the activity of lower extremities and 2 cm contraction of the affected limbs, while the other patients had no obvious shortening and no effect on daily activities. Conclusion traditional surgery combined with intraoperative adjuvant treatment of chondroblastoma can obtain good clinical effect.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R738.3
，
本文编号：2195098
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