囊内刮除术和囊外切除术对股骨巨细胞瘤的治疗效果对比研究

目的 探讨囊内刮除术和囊外切除术对股骨巨细胞瘤治疗效果的影响.方法 纳入确诊为股骨近端骨巨细胞瘤的患者96例,其中60例行囊内刮除术,36例行囊外切除术,比较两组患者在随访48个月内总体复发率.结果96例患者在随访48个月内无死亡病例,首次手术后24个月内66.7%出现复发,60例行囊内刮除术患者复发率为20.0%,36例囊外切除术患者复发率为0(P<0.05);按照Mankin评分标准对手术的效果进行评价,囊内切除术得分为(28.4±5.2)分,优良率为80.0%,囊外切除术得分为(22.6±4.3)分,综合评价优良率为55.5%.结论 对于骨巨细胞瘤,内囊刮除术能保持正常的解剖结构,但具有一定的复发率,囊外切除术能做到广泛切除,复发率低.

Comparative Study of Intracapsular Curettage and Extracapsular Resection for Giant Cell Tumor of Femoral

Objective To investigate the therapeutic efficacy of intracapsular curettage and extracapsular resection for giant cell tumor of femoral .Methods 96 cases of ±giant cell tumor of the proximal femur were selected , 60 cases received rou-tine intracapsular curettage ,36 cases received luggage outside resection ,overall recurrence rates between the 2 groups were com-pared in the 48 months follow-up.Results There had no deaths in 96 patients ±during follow-up within 48 months,there had 66.7%recurrence within 24 months after the first surgery ,relapse rate of 60 cases treated with routine intracapsular curettage was 20.0%, relapse rate of 36 cases treated with extracapsular resection was 0 (P<0.05);effects of surgery was evaluated by Man-kin score,intracapsular resection score was (28.4 ±5.2) points,excellent rate was 80.0%,extracapsular resection score was (22.6 ±4.3) points,comprehensive evaluation excellent rate was 55.5%.Conclusion For giant cell tumor of bone ,internal capsule curettage can maintain normal anatomic structure ,but it has certain recurrence rate ,extracapsular surgery can achieve ex-tensive resection with low recurrence rate .