重复应用微波高温灭活治疗股骨远端骨巨细胞瘤

Effect of repeated microwave hyperthermia inactivation on distal femur giant cell tumor

目的探讨重复应用微波高温灭活治疗股骨远端骨巨细胞瘤的临床应用效果。方法回顾性分析我科2006年6月-2012年6月采用重复应用微波高温灭活方法治疗股骨远端骨巨细胞瘤11例,男7例,女4例,年龄19~42岁,中位年龄27岁,术后自体髂骨、骨水泥修复骨缺损从手术技术、肿瘤复发情况、膝关节功能等方面全面综合评价此方法临床应用效果。结果全部患者均获得随访,平均随访时间26个月,11例均获得骨性愈合,无骨折及内固定断裂发生,1例在术后18个月局部复发;无伤口并发症及深部感染发生,无远处转移。肢体关节功能优8例、良3例。结论微波原位灭活后再行微波辅助残腔灭活,可以有效灭活术后残腔和周围肿瘤卫星灶。术后行自体髂骨、骨水泥修复骨缺损,可以早期负重活动,获得良好的关节功能锻炼,缩短疗程,从而获得优良的疗效及肢体关节功能。

Objective To study the effect of repeated microwave hyperthermia inactivation on distal femur giant cell tumor.Methods Clinical data about 11 patients（7 males and 4 females） aged 19-42 years old（mean 27 years old） with distal femur giant cell tumor who underwent repeated microwave hyperthermia inactivation in our department from June 2006 to June 2012 were retrospectively analyzed.The effect of repeated microwave hyperthermia inactivation on repair of knee-cap defect with bone cement was assessed from the aspects of tumor reccurrence and knee joint function after operation.Results The patients were followed up for an average period of 26 months,during which the knee-cap was healed without fracture,internal fixation plate rupture,complication,deep infection,and distal metastasis.Local recurrence occurred in 1 patient 18 months after operation.Excellent and good functions of joints were achieved in 8 and 3 patients,respectively.Conclusion Combined in situ microwave hyperthermia inactivation and residual cavity microwave hyperthermia inactivation can effectively inactivate the residual cavity tumor and its adjacent foci,and repair the knee-cap defect with bone cement.The patients can carry out physical exercises with a heavy burden early after operation and shoten the course of treatment,thus improving their joint function.