摘要
目的探讨瘤体刮除骨水泥填充保膝手术与瘤段切除肿瘤型假体置换治疗膝关节周围骨巨细胞瘤的临床疗效。方法选取膝关节周围骨巨细胞瘤患者,将采用瘤段切除肿瘤型假体置换术治疗的患者纳入至置换组,将瘤体刮除骨水泥填充保膝手术治疗的患者纳入至保膝组。置换组26例,保膝组34例。收集两组患者围术期指标、国际骨与软组织肿瘤协会保肢评分(musculo skeletal tumor society,MSTS)、美国纽约特种外科医院评分(hospital for special surgery,HSS)、复发情况,单因素分析影响骨巨细胞瘤术后复发的因素。结果保膝组手术时间明显短于置换组,P<0.05,保膝组患者术中出血量、住院费用均明显少于置换组,P<0.05,但两组患者住院时间比较,P>0.05。术前两组MSTS评分、HSS评分比较,P>0.05,术后6个月及末次随访,保膝组MSTS评分、HSS评分均更高,P<0.05。通过末次随访发现,复发12例(20.00%),未复发患者48例(80.00%)。单因素分析得出影响骨巨细胞瘤术后复发的因素为Campanacci分级和肿瘤体积(P<0.05)。结论瘤体刮除骨水泥填充保膝手术治疗膝关节周围骨巨细胞瘤较瘤段切除肿瘤型假体置换术疗效更优,其复发可能与病理分级或肿瘤体积相关。
Objective To investigate the clinical efficacy of tumor curettage and cement-filled knee preservation surgery and segment resection for tumor type prosthesis replacement in the treatment of giant cell tumor of bone around the knee.Methods The patients with giant cell tumor of bone around the knee were selected,and the patients treated with segmental-resection tumor prosthesis replacement were included in the replacement group,and the patients treated with bone cement filling knee preservation surgery were included in the knee preservation group.There were 26 cases in the replacement group and 34 cases in the knee preservation group.Perioperative indicators,musculo skeletal tumor society(MSTS),hospital for special surgery(HSS)in New York,USA,and recurrence of the 2 groups of patients were collected.The factors influencing the recurrence of giant cell tumor of bone after operation were analyzed.Results The operative time of the knee preservation group was significantly shorter than that of the replacement group,P<0.05.The amount of intraoperative blood loss and hospitalization cost of the knee preservation group were significantly shorter than that of the replacement group,P<0.05,but the hospitalization time of the 2 groups was compared,P>0.05.Before surgery,MSTS score and HSS score were compared between the 2 groups,P>0.05,6 months after surgery and the last follow-up,MSTS score and HSS score were higher in the knee preservation group,P<0.05.At the last follow-up,12 patients(20.00%)relapsed and 48 patients(80.00%)did not.Univariate analysis showed that the factors affecting the recurrence of giant cell tumor of bone were Campanacci grade and tumor volume(P<0.05).Conclusion The treatment effect of tumor curettage and cement-filled knee preservation surgery is better than that of segment resection for tumor type prosthesis replacement,and its recurrence may be related to pathological grade or tumor volume.
作者
邢林卿
胡明鑫
徐长波
董永浩
王勇
尤笑迎
XING Linqing;HU Mingxin;XU Changbo(The Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou,450000)
出处
《实用癌症杂志》
2024年第2期346-348,共3页
The Practical Journal of Cancer
关键词
膝关节周围骨巨细胞瘤
瘤体刮除骨水泥填充保膝手术
瘤段切除肿瘤型假体置换术
临床疗效
Giant cell tumor of bone around knee joint
Curettage of tumor body and bone cement filling knee conserving surgery
Tumor segment resection and tumor prosthesis replacement
Clinical efficacy
