成年人单纯性骨囊肿两种治疗方法疗效对比

目的 探讨成年人单纯性骨囊肿的有效治疗方法.方法 将48例成年人单纯性骨囊肿患者按照就诊顺序随机分成两组:激素组20例,采用醋酸泼尼松龙注射疗法;异体骨植骨组28例,采用病灶清除、同种异体骨移植治疗.对两组单纯性骨囊肿患者的疗效进行对比分析.结果 全部患者均获得随访,随访时间5～46(26.58±10.81)个月,根据Chigira等对骨囊肿骨愈合的X线评价标准,激素组Ⅰ级1例、Ⅱ级2例、Ⅲ级10例、Ⅳ级7例,异体骨植骨组Ⅰ级0例、Ⅱ级3例、Ⅲ级5例、Ⅳ级20例.激素组治愈率为85.0%(17/20),异体骨植骨组治愈率为89.3%(25/28),两组比较差异无统计学意义(P＞0.05).结论 尽管成年人单纯性骨囊肿采用醋酸泼尼松龙注射疗法与病灶清除、同期异体骨移植治疗的疗效差异无统计学意义,但对于溶骨性改变较明显的下肢负重骨囊肿,建议手术治疗,上肢骨或骨皮质相对完整的下肢负重骨囊肿建议行激素治疗.

Comparison of two remedy for treatment of simple bone cyst in adult

Objective To approach the effective treatment for simple bone cyst in adult. Methods Forty-eight cases were divided into two groups by visiting order, 20 cases (steroid group) were treated by prednisolone acetate and 28 cases (open resection and allograft group) were treated by open resection and allograft. The curative effect were contrasted between two groups. Results The follow-up time was 5-46(26.58 ± 10.81) months. Aecording to the Chigira's healing criteria for simple bone cyst, grade Ⅰ , Ⅱ , Ⅲ,V were 1, 2, 10 and 7 cases respectively in steroid group, contrasting to 0, 3, 5 and 20 cases respectively in open resection and allograft group. The recovery rate was 85.0%(17/20) in steroid group and 89.3%(25/28) in open resection and allograft group, which was no statistically significant difference between two groups (P＞0.05). Conclusions Although the two remedies are no obvious difference in curative effect,simple bone cyst at lower extremity of weight-bearing with obvious osteolysis in adult is recommended to open resection and allograft, otherwise or at upper extremity to steroid injection.