骨巨细胞瘤临床分级与手术方法

Clinical grading and surgical approaches for bone giant cell tumor

目的探讨骨巨细胞瘤临床、病理、X线分级和各种术式的选择与疗效。方法对107例经手术病理证实的骨巨细胞瘤患者，根据临床、病理、X线分级程度采用刮除植骨、骨水泥填充、大块切除、人工关节置换等不同手术方式进行治疗。通过随访观察疗效。结果随访6～70个月（平均24个月）。刮除植骨14例，复发2例；刮除骨水泥填充术42例，复发4例；肿瘤骨大块切除，带血管腓骨髂骨重建25例，复发1例；瘤段切除26例，均无复发。结论骨巨细胞瘤的临床症状、病例、X线三结合综合分期，对确定其属性和程度，正确估计预后和选择适当的手术方案有重要的临床意义。

Objective To investigate the clinical, pathology and roentgenograph grading and surgical approaches for bone giant cell tumor as well as the effects. Methods 107 cases with hone giant cell tumor were undergone focus curettage with bone graft, cement intilling, massive resection or arthroplasty according to the clinical, pathology and roentgenagraph grading. The effects were studied. Results All cases were followed up for 6 ~ 20 months, 24 on average. Of 14 cases with focus curettage with bone graft, 2 got recurrence; Of 42 cases with focus curettage with cement infdling, 4 got recurrence; Of 25 cases with massive resection and vascularized fibular or iliac reconstruction, 1 got recurrence; Of 26 cases with segmental resection, no recurrence was found. Conclusions The clinical, pathology and roentgenograph grading of bone giant cell tumor is essential for determining its characteristics, prognosis and selection of treatment protocol.