| 恶性骨肿瘤的误诊误治分析 |
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| 引用本文： | 马保安,范清宇.恶性骨肿瘤的误诊误治分析[J].中华骨科杂志,1996,16(5):309-311. |
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| 作者姓名： | 马保安 范清宇 |
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| 作者单位： | 第四军医大学唐都医院骨科 |
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| 摘 要： | 作者于１９９１～１９９４年，共收治曾有过不同程度误诊、误治的恶性骨肿瘤病人２５例，其中７例误诊为良性肿瘤行刮除植骨术或误诊为炎性病变行病灶清除术，５例活检失当，余病人虽诊断明确但未采取系统、有效的方法治疗以至延误保肢手术时机。我们认为：骨肿瘤的诊断应以临床、放射、病理三者结合，避免将一些缺乏典型Ｘ线特点的恶性骨肿瘤误诊为良性肿瘤。缺乏经验的诊断性活检易造成切口肿瘤细胞种植，导致保肢手术困难，应尽量避免术前活检。对一些诊断困难的病例，应由有经验的医生从事慎重、细致的术前活检。在治疗上以手术治疗为主，辅以放疗、化疗及免疫治疗等。为避免恶性骨肿瘤的误诊误治，应尽快在国内建立数个骨肿瘤治疗中心及转诊作业系统
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| 关 键 词： | 恶性骨肿瘤 误诊 误治 |
MisdiagnosisandMaltreatmentofPrimary |
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| MalignantBoneTumorsMaBaoan,FanQingyu.Depart-mentofOrthopaedics,AffiliatedTangDuHospital,theFourthMilitaryMedicalUniversity,Xi'an.MisdiagnosisandMaltreatmentofPrimary[J].Chinese Journal of Orthopaedics,1996,16(5):309-311. |
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| Authors: | MalignantBoneTumorsMaBaoan FanQingyuDepart-mentofOrthopaedics AffiliatedTangDuHospital theFourthMilitaryMedicalUniversity Xi'an |
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| Institution: | MalignantBoneTumorsMaBaoan,FanQingyu.Depart-mentofOrthopaedics,AffiliatedTangDuHospital,theFourthMilitaryMedicalUniversity,Xi'an710038 |
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| Abstract: | From1991to1994,25casesofprimarymalignantbonetumorsweretransferredfromotherhospitalstothisdepartment.Althecaseshadreceivedunsuitabletreatmentpreviously.Sevencaseshadthelesionsthoroughlycurettedandpackedwithbonechipsonthemisdiagnosisofbenignle-sions,5underwentinadequatebiopsies,andtheothershadnoregularsystemicandefectivetreatmentforalongperiodoftime,sothattheopportunitiesofalimb-salvageprocedurewerelost,althoughthediagnoseswereestablishedcorrectly.Basedontheanalysisofthesecases,theauthorsconcludedthatthecorrectdiagnosisofmalignantbonetumorsshouldbebasedontheclinicfeatures,theroentgeno-graphicfindingsandthepathologicalfindingssothatmisdiagnosisofthelesionscouldbeprevented.Thepre-operativebiopsyshouldbedonewithdiscretionbyexperiencedsurgeons.Thebiopsymustbeadequatewithoutthedangerofseedingtumorcelsinthevincitysoastoprovidetheconditionforalimbsavingprocedureifitisindicated.Inthetreatmentofprimarymalignantbonetumors,surgicalresec-tionofthelesionisthefirstchoice,andadjuvanttherapy,suchaschemotherapy,radiationandim-munotherapycanbeusedinaddition.TheauthorsproposedtheestablishmentofmorethanoneBoneTumorTreatmentCentersacrossthecountrytoadmittransferanceofbonetumorcasesfromhospitalsatthegenerallevel. |
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| Keywords: | MalignantbonetumorsMisdiagnosisMaltreatment |
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