单纯性骨囊肿104例的临床研究

Clinical study on simple bone cyst:a report of 104 cases

目的研究单纯性骨囊肿的发生、转归、治疗方法及效果。方法104例单纯性骨囊肿患者按治疗方法分为4种:82例采用甲基强的松龙注射疗法、7例采用骨髓移植注射治疗、13例采用病灶清除加同种异体骨移植治疗、2例采用病灶清除加自体骨移植。采用甲基强的松龙注射治疗的患者分为A、B两组,A组为活跃型病例,B组为静止型病例。平均随访4.5年,对104例单纯性骨囊肿患者的临床资料、治疗方法、治疗效果进行分析。结果A组42例患者中愈合11例(26.19%),部分愈合16例(38.10%),未愈15例(35.71%);B组40例患者中愈合19例(47.50%),部分愈合17例(42.50%),未愈3例(7.50%)。经SPSS软件包统计分析得出B组患者治疗效果明显优于A组(P<0.005)。甲基强的松龙注射治疗、骨髓移植注射治疗、病灶清除加异体骨移植三种疗法的疗效无明显区别(P=0.151)。结论活跃型病例的治愈率较静止型病例的治疗效果差,单纯性骨囊肿的发生可能和骨骺成骨时的成骨功能紊乱有关;甲基强的松龙注射治疗、骨髓移植注射治疗、病灶清除加异体骨移植三种疗法的疗效无明显区别,但甲基强的松龙注射治疗安全,并且疗效可靠、操作简单。

Objective To study the occurrence,turnover of simple bone cyst,and to explore the therapy and curative effect for simple bone cyst. Methods The patients with simple bone cyst were treated by Depo-Medrol injection（ n = 82）, bone marrow injection（ n = 7 ） , debridement and allograft（ n = 13 ）, debridement and autograft（ n = 2）. The patients treated with methylprednisolone injection were divided into group A（ active cases） and group B（ inactive cases）. Mean follow-up period was 4.5 years. The clinical data and curative effects were analyzed and compared. Results Of 42 cases, 11 cases （26.19% ）and 19 （47.50%）were healed in group A and group B,respectively;16 cases （ 38. 10% ） and 17 （ 42. 50% ） were partially healed in group A and group B; 15 cases （ 35.71% ） and 3 （7.50%） were unhealed. The curative effect in group A was better than in group B （P 〈 0. 005 ）. The curative effect of methylpred- nisolone injection and curettage plus allografts and bone marrow infiltration showed no significant difference（P = 0. 151 ）. Conclusion The curative effect of the active cases is better than that of inactive cases. The occurence of simple bone cyst may be related to the disturbance of osteogenesis function during physis. Methylprednisolone injection is a safe and reliable method for simple bone cyst.