病灶刮除骨水泥填充治疗骨巨细胞瘤

目的 :观察采用刮除、酒精灭活及骨水泥填充相结合治疗骨巨细胞瘤的疗效。方法 :对 1980年 6月～ 1998年 3月 ,经刮除、酒精灭活加骨水泥填充治疗的骨巨细胞瘤 98例进行随访。男 45例 ,女 5 3例。发病部位 ,股骨下端48例、胫骨上端 2 4例、肱骨上端 7例、桡骨远端 8例、股骨上端 3例、髂骨 2例、骶骨 4例、肱骨下端、尺骨各 1例。结果 :术后平均随访时间为 5年 3个月 ,1年内复发率 5 .9% ,3年内复发率 12 .9% ,5年内复发率为 13.9%。结论 :强调手术过程中刮除的精细操作、酒精灭活和骨水泥填充时的再灭活作用 ,提出彻底刮除、酒精灭活和骨水泥填充手术可以使囊内切除手术达到邻界切除手术的效果。

Surgical Curettage of Giant Cell Tumor of Bone

Objective: To evaluate the effect of treating giant cell tumor of bone (GCT) with surgical curettage. Methods: From 1980 to 1998, 98 patients with giant cell tumor of bone were treated by thorough curettage, alcohol deactivation of tumor and packing the cavity with bone cement. There were 45 males and 53 females with mean age of 30.2 years. Involvement of distal femur was found in 48 cases,proximal tibia 24, proximal humerus 7, distal radius 8, proximal femur 3, ilium 2,sacrum 4, ulna 1 and distal humerus 1. The curettage must be complete and the cavity was deactivated with 95%alcohol and padded with bone cement. Results: The mean postoperative follow-up period was 5.3 years . The recurrence rates at 1-, 3-and 5-year follow up were 5.9%, 12.9%and 13.9%respectively. Conclusion: Curettage treatment is good for giant cell tumor of bone but complete curettage up to normal tissues is crucial step in the procedure.