骨肿瘤介入治疗的选择与价值(附76例分析)

The determination of and the evaluation on the interventional therapy for bone tumor:76 cases of analysis

目的 了解、评估介入治疗在骨肿瘤治疗中的选择与价值。方法 92～ 97年 76例骨肿瘤行介入治疗 ,然后根据具体情况予手术及非手术治疗 ,观察临床、手术情况 ,定期随访。结果 1.介入治疗总有效率 85 % ,四肢骨肿瘤的有效率为 92 % ;2 .介入治疗不仅使 86%的肿瘤手术中供血减少 ,而且使肿瘤全部坏死达Ⅲ以上 ,假包膜出现率 66% ,肿瘤完整切除率 75 % ;3 .严重并发症 7例 ,发生率 10 % ,主要为皮肤坏死。结论 介入治疗的疗效明显 ,其作用在于 :使肿瘤坏死缩小 ,分界变清 ,减少肿瘤血供 ,有利于完整切除肿瘤 ,减少局部复发 ,提高手术成功率。主要适用于 :1.恶性骨肿瘤拟行保肢术者 ;2 .良性或中间性骨肿瘤破坏范围较大已难以保留患骨、预计肿瘤供血丰富者。 3 .

? Objective To evaluate the value of interventional therapy in treating bone tumors.Methods 76 patients from 1992 to 1997 with bone tumor underwent interventional therapy,then operation or non operative treatments accordingly.They were followed up regularly.Results Effective rate was 85% in interventional group,and was 92% for limb bone tumors. Intervention treatment caused Ⅲ or Ⅳ degree necrosis in all cases,reduced the blood supply in operation in 86% cases,formation of false membrane occurred in 66% cases,total removal of the tumors was carried out in 75% cases.complications which were mostly skin necrosis occurred in 10% cases (7 cases);Conclusions Intervention therapy can cause tumors necrosis and shrink,clarify the edge,decrease blood supply to tumor for the sake of rmoving the tumors thoroughly,decreasing local recurrence and improving successful rate of the operation.The indications are including the cases with malignant tumor intended to be treated by limb saving procedure;benine or borderline tumors with wide range destruction which is difficult to remain the affected bone and with rich blood supply and some terminal metastasis bone tumor. 〔