儿童骨嗜酸细胞性肉芽肿的诊断与治疗

The diagnostic and therapeutic method of eosinophilic granuloma of bone in children

目的对我院22例儿童骨嗜酸细胞性肉芽肿的临床资料进行分析,讨论其临床病理特点及影像学改变,探讨其治疗方法。方法收集2000年以来我院22例骨嗜酸细胞性肉芽肿病例,结合文献对其临床表现、诊断、治疗等进行总结分析。结果22例临床诊断为骨嗜酸细胞性肉芽肿,15例经病理证实,予手术刮除病灶或病灶加植骨治疗;7例采取非手术治疗,全部病例随访2个月～3年,其中2例合并韩-薛-柯病的患儿检查化疗,2例手术病人于2年后复发,予再次手术治疗,其余病例复查X光片病灶愈合良好。结论骨嗜酸细胞性肉芽肿多见于儿童与青少年,以骨质破坏、组织细胞增生和嗜酸性细胞浸润为主要病理特点,临床症状不典型,X线片是主要诊断方法,CT和MRI对其诊断帮助不大,治疗上应依据病灶情况选择相应的治疗方案。

Objective To explore the diagnostic and therapy method of eosinophilic granuloma of bone in childrens. Methods 22cases of eosinophilic granuloma of hone were collected in our hospital since 2000. these patients age ranged from 1 months to 12 years （mean 3.5 years）. their clinical manifestation, diagnosis and therapeutic schedule were summarized and retrospectively analyzed combined with literatures. Results 17 of 22 cases were clinical dignosed as eosinophilic granuloma of bone,and 15 of them were confirmed using pothological examination,these patients underwent focal curettage or focal bone grafting therapy, 7 cases have undergoing conservative therapy. All cases were followed up for 2 months to 3 years. 2 cases of them occurred complication, relapse after the 2 years underwent chemotherapy check and again using operation treatment. All the other cases were followed up using X-ray examination,results showed that focus healing was favoable. Conclusions Ppopulation affected with eosinophilic granuloma of bone mainly is children and juveniles,patholgical features major are osteodestroy,tissue cell proliferation and eosinophilic cell infiltration, it have not classic clinical symptom. X-ray film is major diagnostic method, examination of CT and MRI being not too for the diagnosis of the eosinophilic granuloma of bone. Based on the focus situation,we can choose the corresponding therapy way for the disease.