手术治疗骨巨细胞瘤44例分析

目的 分析比较不同手术方法治疗四肢长骨骨巨细胞瘤的临床效果。方法 回顾分析1991年11月-2005年9月手术治疗的44例骨巨细胞瘤。结果 44例患者均获得随访，随访时间10个月至14年1个月，平均10年2个月。病灶刮除植骨11例，肿瘤复发3例；病灶刮除骨水泥填充16例，肿瘤复发2例；瘤段切除灭活再植7例，肿瘤复发1例；瘤段切除关节融合3例，肿瘤复发0例；瘤段切除人工假体置换7例，肿瘤复发0例。病灶刮除组总复发率19％，瘤段切除总复发率为6％。结论 病灶刮除骨水泥填充术和肿瘤瘤段切除术均是治疗骨巨细胞瘤的可靠方法。

An Analysis of Curettage and En Block Resection of Giant Cell Tumor of Bones (44 Cases)

Objective To evaluate the clinical results of the giant cell tumor of bones treated with curettage or en block resection.Methods By reviewing and analyzing the 44 patients with giant cell tumors of the extremities.They were treated by curettage and en block resection from 1991 to 2005.Results All the cases were followed up for 10 years and 2 months in average (10 months-14 years and 1 month).3 of 11 cases treated with curettage and bone grafting relapsed.2 of 16 cases treated with curettage and packing with cement relapsed.1 of 7 cases treated with inactivation-replantation relapsed.None of 3 cases treated with en block resection and fusion of joint relapsed.None of 7 cases treated with en block resection and artificial joint prosthetic replacement relapsed.The local recurrence rate was 19% in the curetted group and 6% in the en block resection group.Conclusions Both curettage and en block resection were effective and safe in treatment of giant cell tumor of bones.