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目的 探讨病灶切刮骨水泥填充治疗肢体骨巨细胞瘤 (GCT)的临床应用价值。 方法对 1980年 3月～ 1997年 12月 12 5例GCT的治疗情况进行回顾分析。患者男 62例 ,女 63例 ,年龄 12～ 71岁 ,平均年龄 3 1 5岁 ,其中原发GCT 10 1例 ,复发GCT 2 4例。发病部位在膝关节周围者 10 0例(占 80 % )。 结果 12 5例患者均获随访 ,随访时间 13～ 194个月 ,平均 96个月。原发GCT者 ,13例复发 ,复发率为 12 7% ;复发组再复发率为 10 3 %。两组 13 0例次切刮骨水泥填充术后 ,仅 2例出现伤口不愈合 ,继发感染 ,随访时关节功能良好。 结论 病灶切刮骨水泥填充治疗肢体GCT ,方法简便有效 ,复发率低 ;病灶开窗大小及是否能直视下操作、切刮结合 ,以骨刀切除囊壁骨嵴残留肿瘤是影响手术成败的关键因素 ;骨水泥填充作为一种辅助方法 ,相对于植骨 ,可早期负重 ,早期锻炼关节功能。
Objective To investigate the clinical application value of the treatment of bone cement giant cell tumor (GCT) with lesion-cutting and scraped cement. Methods The retrospective analysis of the treatment of 5 cases of GCT from March 1980 to December 1997 was performed. There were 62 males and 63 females, aged from 12 to 71 years, with an average age of 315 years. Among them, there were 101 primary GCTs and 24 GCTs. There were 10 cases (80%) of the lesions around the knee. Results All 15 patients were followed up for 13 to 194 months with an average of 96 months. Among the patients with primary GCT, 13 had recurrence and the recurrence rate was 127%. The recurrence group had a recurrence rate of 10 3%. Two groups of 1300 cases of sub-cutting cement injection, only 2 cases of wound nonunion, secondary infection, joint function at follow-up. Conclusions The treatment of limb GCT with focal scraped cement is simple and effective, and the recurrence rate is low. The size of the open window and whether it can be operated under direct vision, cutting and scraping combined, and the residual tumor of cyst wall osteophyte taken with a bone knife is an effect on the success or failure of surgery. Key factors: Bone cement filling is an auxiliary method. Compared with bone grafting, it can be loaded early and exercise the joint function early.