以刮除植骨为主治疗四肢骨巨细胞瘤的临床观察

目的　观察以刮除植骨术为主治疗四肢骨巨细胞瘤的疗效。方法　收集２０００年５月至２００８年５月采用刮除植骨治疗骨巨细胞瘤３６例，根据肿瘤部位及骨质破坏的程度采取不同的手术方法，其中单纯刮除植骨或骨水泥填充１７例，刮除植骨内固定１９例，且在术前术后予以辅助治疗。结果　随访时间１.５～９.５年，平均５年，５例复发，复发率为１３.９％；术后患者肢体功能评定：优１９例，良１１例，中３例，差３例，总体满意率为９１.７％。结论　病灶刮除植骨是骨巨细胞瘤基本的外科治疗方法，局部辅助处理措施如高速磨钻磨削、蒸馏水浸泡可达到安全的外科治疗边界，术后予以双膦酸盐辅助治疗可以降低病灶刮除术后的复发率，且术后肢体具有良好的功能。

Surgical therapy for giant cell tumor of bones with tumor curettage and bone graft

Objective To evaluate the efficacy of giant cell tumors of bones treated with tumor curettage and bone graft.Methods Thirty-six patients with giant cell tumors in extremes were treated with tumor curettage and bone graft from May 2000 to May 2008 were reviewed.Seventeen cases performed tumor curettage with bone graft or cementation,and 19 cases received internal fixation with bone graft curettage.Adjuvant therapy was given before and after operation.Results The mean follow-up time was 5（1.5-9.5）years.The recurrence rate was 13.9%（5 cases）.Using MSTS functional evaluation：excellent in 19 cases,good in 11 cases,normal in 3 cases and poor in 3 cases.The overall satisfactory rate was 91.7%.Conclusion Curettage and bone graft are still the elemental surgical therapy to treat the giant cell tumor of bone.Adjuvant treatment such as high speed grinding and distilled water immersion could reduce recurrence rate,and provide good limb function.