扩大刮除术治疗软骨母细胞瘤的疗效观察

发布时间：2018-05-18 13:34

本文选题：软骨母细胞瘤 + 扩大刮除术　；参考：《中国修复重建外科杂志》2017年12期

【摘要】：目的探讨扩大刮除术治疗软骨母细胞瘤的疗效。方法回顾性分析2011年1月—2016年5月,采用病灶扩大刮除术治疗的37例软骨母细胞瘤患者临床资料。男24例,女13例;年龄12~30岁,中位年龄17岁。原发患者32例,复发患者5例。患者均以局部疼痛为首发症状。病程2~8个月,平均4.9个月。病变部位:股骨远端10例,股骨近端7例,胫骨近端9例,肱骨近端5例,髌骨2例,距骨1例,跟骨1例,骨盆2例。根据良性骨肿瘤的Enneking分期均为3期。病灶长径为1.2~6.9 cm,平均3.2 cm。19例病变累及骺板。结果术后切口均Ⅰ期愈合,无相关并发症发生。患者均获随访,随访时间12~76个月,平均40.5个月。末次随访时国际肌肉骨骼肿瘤学会(MSTS)评分为(27.5±1.4)分,与术前(18.5±1.9)分比较,差异有统计学意义(t=23.462,P=0.000)。术后5个月复发1例(2.7%)。X线片复查示,6例出现部分植骨吸收,但植骨区关节面未见明显塌陷。3例骺板受累且病变位于膝关节周围者,出现肢体短缩畸形,但无内外翻畸形,膝关节活动未受影响。结论扩大刮除术治疗软骨母细胞瘤具有术后复发率低、肢体功能良好、骨骼发育畸形发生率低等优点,是治疗该疾病较好方法。
[Abstract]:Objective to investigate the effect of expanded curettage on chondroblastoma. Methods the clinical data of 37 patients with chondroblastoma treated by extensive curettage from January 2011 to May 2016 were retrospectively analyzed. There were 24 males and 13 females aged 1230 years with a median age of 17 years. 32 cases were primary and 5 cases relapsed. Local pain was the first symptom in all patients. The course of disease ranged from 2 to 8 months (mean 4.9 months). The lesions included 10 cases of distal femur, 7 cases of proximal femur, 9 cases of proximal tibia, 5 cases of proximal humerus, 2 cases of patella, 1 case of talus, 1 case of calcaneus and 2 cases of pelvis. According to the benign bone tumor, the Enneking staging was 3 stages. The length and diameter of the lesion was 1. 2 ~ 6. 9 cm, with an average of 3. 2 cm.19 involving epiphyseal plate. Results all the incisions healed in the first stage, and there were no related complications. All patients were followed up for 12 ~ 76 months (mean 40.5 months). At the last follow-up, the MSTS score of the International Society of Musculoskeletal Oncology was 27.5 卤1.4, which was significantly higher than the preoperative score of 18.5 卤1.9. The difference was statistically significant. 5 months after operation, 1 case recurred 2. 7% and 6 cases showed partial bone graft absorption, but there was no obvious collapse on the articular surface of bone graft area. 3 cases with epiphyseal plate involvement and lesion located around the knee joint showed short limb deformity, but no internal and external varus deformity. Knee joint movement was not affected. Conclusion the treatment of chondroblastoma with expanded curettage has the advantages of low recurrence rate, good limb function and low incidence of skeletal malformation. It is a better method for the treatment of chondroblastoma.
【作者单位】：中南大学湘雅医院骨科;
【基金】：中南大学研究生自主探索创新项目基金(2017zzts900)~~
【分类号】：R738.1

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