骨巨细胞瘤手术治疗的疗效

Efficacy of surgical treatment of giant cell tumer of bone

目的探讨骨巨细胞瘤手术治疗的临床效果。方法 2000年8月至2010年9月手术治疗33例骨巨细胞瘤患者,其中肿瘤切除﹢石炭酸烧灼、酒精局部灭活﹢骨水泥填塞术10例;病灶刮除﹢植骨6例;单纯瘤段切除5例;瘤段切除人工假体置换5例;瘤段切除关节融合4例;病灶刮除术治疗Ⅲ期患者3例。结果全部患者均获得随访,随访时间6个月～4.5年,平均2.6年。病灶刮除骨水泥填充10例,肿瘤复发2例;病灶刮除植骨6例,肿瘤复发1例;单纯瘤段切除5例,肿瘤复发1例;瘤段切除人工假体置换5例,肿瘤复发0例。瘤段切除关节融合4例,肿瘤复发0例;病灶刮除术治疗Ⅲ期患者3例,肿瘤复发1例。结论手术治疗骨巨细胞瘤的临床效果是令人满意的,但其复发是一个值得注意的问题。

Objective To investigate the clinical results of surgical treatment for patients with giant cell tumor（GCT） of bone.Methods Thirty-three patients with giant cell tumors were treated by curettage and en block resection between Aug.2000 and Sep.2010.Out of the thirty three cases,10 cases were treated by the management of the tumor resection plus local devitalization with carbolic acid or 95% alcohol cauterization and filled by bone cement.Six cases were treated with curettage and bone grafting.Five cases were treated with en block resection and artificial joint prosthetic replacement.Four cases were treated with en block resection and fusion of joint.Three cases in grade Ⅲ were treated with curettage.Results All the cases had been followed up from 6 months to 4.5 years（averaged 2.6 years）.Two of 10 cases treated with curettage and packing with cement relapsed.One of 6 cases treated with curettage and bone grafting relapsed.One of 5 cases treated with inactivation-replantation relapsed.No one of 5 cases treated with en block resection and artificial joint prosthetic replacement relapsed.No one of 3 cases treated with en block resection and fusion of joint relapsed.One of 3 cases in grade Ⅲ treated with curettage relapsed.one of 7 cases in Grade Ⅲ treatedwith en block resection relapsed.The local recurrence rate was 19.2% in the curetted group and 7.7% in the en block resection group.The overall satisfactory rate of therapy was 82.0%,however,the unsatisfactory rate was 18.0%.Conclusion The clinical result of surgical treatment for patients with GCT of bone was satisfactory.However,relapse of GCT of bone are discomforting.