摘要
目的探讨四肢长骨非恶性初发骨巨细胞瘤刮除植骨术与刮除骨水泥填充术治疗的疗效,为临床治疗提供参考依据。方法回顾性分析2005年1月—2013年1月经本院收治手术病例证实的四肢长骨初发非恶性骨巨细胞瘤患者53例。按其病灶刮除后植入材料的不同分为两组,肿瘤刮除骨水泥填充组27例,Jaffe病理学Ⅰ级13例,Ⅱ级14例。肿瘤刮除植骨术填充组26例,Jaffe病理学Ⅰ级11例,Ⅱ级15例;分别观察两组1年和3年术后疗效并做出比较。结果参加入组研究患者均获得随访,平均(36.7±1.2)个月,其中根据Mankin疗效评定标准:Ⅰ~Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后1年复发率(8.1%)低于刮除植骨组(44.4%)(χ~2=4.72,P<0.05)。Ⅰ~Ⅱ级骨巨细胞瘤刮除骨水泥填充组术后3年复发率(18.5%)低于刮除植骨组(46.5%)(χ~2=4.64,P<0.05),结果差异均具有统计学意义。结论四肢长骨非恶性初发骨巨细胞瘤刮除骨水泥填充术后1年和3年疗效均优于治疗刮除植骨术组。在临床情况中,从降低术后复发,提高疗效角度考虑,采用肿瘤刮除骨水泥填充术治疗四肢长骨初发非恶性骨巨细胞瘤是较为理想的手术方式。
Objective To compare the therapeutic outcomes of curettages with bone graft and with bone cement filling for initial non-malignant giant cell tumor of long extremity bones. Methods A retrospective review of treatment outcomes was preformed in 53 patients with initial non-malignant GCTs, which were confirmed by surgical pathology and followed up more than 3 years. According to the different treatment method, all patients were divided into 2 groups. Group 1 that was treated by curettage of tumor and packing the cavity with bone cement, consisted of 27 patients. By Jaffe＇s classification, 13 patients had grade 1 and 14 patients had grade II. Group 2 that was treated by curettage of tumor and packing the cavity with bone graft consisted of 26 patients. By Jaffe＇s classification, 11 patients had grade 1 and 15 patients had grade II. Results The therapeutic outcomes were evaluated by Mankin＇s standard. The recurrence rate after 1 year for grades I and II GCT with curettage in the bone cement packing group （8.1%） was lower than that of the bone grafting group （44.4%）（x2=4.72, P 〈 0.05）. The recurrence rate after 3 years in the bone cement packing group （18.5%） was lower than of the bone grating group （46.5%）（x2=4.64, P 〈 0.05）. Conclusion For curettage initial non-malignant GCT of long bones, the 1-year and 3-year therapeutic outcomes of bone cement treatment were better than those of graft treatment.
出处
《中国卫生标准管理》
2017年第10期59-62,共4页
China Health Standard Management
