儿童骨样骨瘤的诊断及治疗体会

目的 分析7例骨样骨瘤的临床及影像学特点，总结诊断经验，探讨治疗方法。方法 对7例骨样骨瘤患者的诊断和治疗进行回顾性分析，病变位于股骨近端4例，胫骨中上段、距骨各1例，股骨远端干骺端和胫骨上端干骺端同时存在1例。2例患者施行传统的手术方法，将整块硬化骨质及瘤巢一并切除，5例患者在C型臂引导下切除瘤巢，所有病例切除组织术后均送病理检查。结果 7例患者术后临床症状均消失，病理报告均为骨样骨瘤，随访2月～8年余无1例复发。结论 骨样骨瘤的诊断主要根据典型的夜间疼痛为主的临床症状及影像学检查发现瘤巢，尤其是CT诊断价值最大；瘤巢的准确定位及彻底切除是获得良好治疗效果的关键，C型臂引导下手术切除局部病灶是较为理想的治疗方式。

Experience of Diagnosis And Treatment For Osteoid Osteoma In Children

Objective To evaluate the clinical and imaging characteristics of osteoid osteoma in 7 cases, in order to enrich diagnostic experience, and explore the best way of treatment. Methods Retrospectively analysed the diagnosis and treatment of 7 cases of osteoid osteoma, 4 cases of osteoid osteoma located at the proximal femur, 2 cases located at the mid-superior part of tibia respectively;talus other one case located at the metaphysis part of both distal femur and proximal tibia, traditional operation way in 2 cases, that's to resect both the ossified osseous tissue and tumour nest, the other 5 cases were carried out excising tumour nest under the guidance of C-model arm. All patients were made pathological examination after the operation. Results The clinical symptoms of all patients were disappeared, all pathological reports confirmed that it was osteoid osteoma.All patients were followed-up for 2 months to more 8 years,there was no one case relapse. Conclusions Diagnosis of the osteoid osteoma is mainly based on the typical pain at night and detection of the tumor nest by radiography, especially computed tomography scan has the most value in the diagnosis of the osteoid osteoma. The tumor nidus accurately location and thoroughly excision of the tumor nest are the key to abtain the satisfactory purpose. So that,excision of the local nidus under the guidance of C-model x-ray arm is a considerable ideal treatment way.