新手术入路治疗股骨小粗隆良性肿瘤临床疗效评价

New operation approach to treat femoral lesser trochanter lesions and clinical curative effects evaluation

目的探讨经股血管和股神经新手术入路治疗股骨小粗隆肿瘤的手术可行性及临床疗效。方法选择2010年1月—2013年1月收治的12例股骨小粗隆良性肿瘤患者,其中骨软骨瘤7例,骨样骨瘤2例,纤维结构不良2例,骨瘤1例,均经股血管、股神经之间进入切除肿瘤。采用视觉模拟评分法(VAS)评估术前、术后疼痛程度。随访时评估影像学资料。结果 12例患者术中病灶显露充分,均完整切除病变组织,术中出血较少。术后VAS评分均较术前明显改善,差异具有统计学意义(P<0.05)。12例患者均获得随访,随访时间0.6～3a,平均随访2.4a。术后影像学检查均未发现肿瘤复发、股骨头坏死、髋关节退变征象。结论经股神经与股血管手术入路可非常理想地显露股骨小粗隆区的病灶,是手术切除股骨小粗隆区肿瘤类病变的理想入路。

Objective To investigate feasibility and clinical effects of the operation approach which between femoral vessels and femoral nerve. Methods Retrospectively collected 12 patients whom had tumor around lesser trochanter during January 2010 to January 2013, osteochondroma in 7 cases, osteoidosteoma in 2 ca- ses, fibrous dysplasia in 2 cases, osteoma in 1 case. All benign tumors were resected by new approach. Pain degree, preoperation and postoperation, was evaluated by Visual Analogue Scale （VAS）. Imaging da- ta was assessed in follow-up. Results Operative region showed lesser trochanter and neoplasm clearly. All tumors were resected totally, intra-operation bleed less. There was significant difference in the VAS score between pre-operation and post-operation （P d0.05）. All of patients followed up for 6 month to 3 years, average time 2.4 years. We used imaging material to evaluate the effectiveness in follow up. No recur- rence, femoral head necrosis, hip degenerative was found by radiographic examination in follow-up. Con- clusion Operation approach between femoral vessel and femoral nerve can show lesser trochanter clearly. It is ideal approach to treat lesion around lesser trochanter.