原位微波灭活瘤段＋重建治疗骨巨细胞瘤的临床观察

目的应用微波原位灭活瘤段＋重建技术治疗骨巨细胞瘤,观察临床疗效和肢体功能。方法 2004年3月至2011年4月本组共应用此方法治疗32例骨巨细胞瘤患者,其中骨盆1例,股骨远端12例,胫骨近端10例,桡骨远端4例,肱骨近端3例,肱骨远端1例,跟骨1例。病理分级：Ⅰ级4例,Ⅱ级11例,Ⅲ级17例。术中边缘外分离肿瘤,原位插入微波针,控制性高温灭活瘤体,自体骨粒或骨水泥填充病灶腔隙,填充骨水泥和异体骨混合物,部分需行内固定,观察术后肿瘤复发和肢体功能评分。结果 32例患者皆得到随访,平均随访2年8个月。发现1例复发,1例感染,肢体关节功能评定：好者28例,可者4例,差者0例。结论原位微波灭活瘤段＋重建技术治疗骨巨细胞瘤可能降低了骨巨细胞瘤术后的复发,并保留较好的肢体功能。

Clinical effects of in situ microwave treatment for giant cell tumor

Objective To investigate the clinical effects, including the limb and joint function after microwave treatment for giant cell tumor. Methods From March 2004 to April 2011, 32 patients were treated by in-situ microwave in our hospital. Primary sites were as follows: pelvis of one patient, distal femur of 12 patients, proximal tibia of 10 patients, distal radius of four patients, proximal humerus of three patients, distal humerus of one patients, and calcaneus of one patient. Pathologic grades were: grade Ⅰin four patients; grade Ⅱin 11 patients; grade Ⅲ in 17patients. The tumor was separated with safe margin, and microwave probes were inserted in situ, which produced controllable hyperthermia to inactivate tumor. The effects and function were investigated in follow-up. Results Among the 32 patients who were followed up for 2.8 years in average, there was one recurred case and one infected case. 28 patients had excellent limb and joint function, and four patients had fair function. Conclusions The clinical results of controllable thermotherapy produced by microwave were excellent for the treatment of giant cell tumor, and this method provides low recurrence and good joint function.