| 谢卫宁,杨英年,甘六央,等.外科治疗肢体骨巨细胞瘤43例.骨科,2016,7(3): 181-184. |
| 外科治疗肢体骨巨细胞瘤43例 |
| Surgical treatment of 43 cases of giant cell tumor of the extremity |
| 投稿时间：2015-04-25 |
| DOI：DOI：10.3969/j.issn.1674-8573.2016.03.009 |
| 中文关键词: 骨巨细胞瘤 四肢 外科手术 |
| 英文关键词: Giant cell tumor of bone Extremities Surgical procedures, operative |
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| 中文摘要: |
| 目的 探讨外科手术治疗肢体骨巨细胞瘤（giant cell tumor of bone, GCT）的临床疗效。方法 回顾性分析2007年1月至2013年7月于我院应用外科手术方法治疗的43例GCT患者，年龄20~66岁（平均32岁）；发病部位：股骨远端17例，胫骨近端16例，桡骨远端5例，腓骨近端2例，股骨近端2例，肱骨近端1例；治疗方法：病灶扩大刮除骨水泥填充并（或不并）内固定及并（或不并）植骨术，瘤段骨切除特制肿瘤关节置换术，瘤段骨切除腓骨小头移植术，瘤段骨切除关节融合术，瘤段骨切除稳定结构重建术。分析本组患者的手术相关资料、术后恢复情况及复发率。结果 43例患者均获得随访，随访时间8~64个月，平均28个月。本组患者的总复发率为7.0%（3/43），其中采用扩大刮除术患者复发率为7.7%（2/26），瘤段切除术患者的复发率为5.9%（1/17），复发患者均经二次手术治疗。2例合并感染，发生率为4.7%。结论 通过术前认真设计，选择恰当的手术方式和重建方式，肢体GCT可获得良好的治疗效果。 |
| 英文摘要: |
| Objective To investigate the surgical effect of giant cell tumor of the extremity. Methods Between January 2007 and July 2013, surgical method was applied to 43 patients, who were 20-66 years old (mean 32 years old). The tumors were located in distal femur (17 cases), proximal tibia (16 cases), distal radius (5 cases), proximal fibula (2 cases), proximal femur (2 cases), and proximal humerus (1 case). Treatments included extensive curettage and cementation with or without bone grafting and with or without internal fixation, en bloc resection and implantation of prosthesis, en bloc resection and fibula capitulum transplantation, en bloc resection and arthrodesis, en bloc resection and stable structure reconstruction. Results After follow-up of 8 to 64 months (mean 28 months), the recurrence rate in extensive curettage group was 7.7%, 5.9% in en bloc resection group, and the overall recurrence rate was 7.0%, similar to the literature. The infection rate was 4.7% (2 cases). Conclusion Through the careful preoperative design, choosing the appropriate operation method and the way of reconstruction, giant cell tumor of the extremity can obtain good therapeutic effect. |
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