经皮自体骨髓注射治疗单纯性骨囊肿疗效评价  

ASSESSMENT OF THERAPEUTIC RESULTS FOR SIMPLE BONE CYST WITH PERCUTANEOUS INJECTION OF AUTOGENOUS BONE MARROW

作　　者：王恩波[1] 赵群[1] 张立军[1] 吉士俊[1] 马瑞雪[2] 

机构地区：[1]中国医科大学附属第二医院小儿骨科,沈阳110004 [2]复旦大学附属儿科医院骨科

出　　处：《中国修复重建外科杂志》2006年第9期925-927,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的评价经皮自体骨髓注射治疗单纯性骨囊肿的疗效，探讨影响疗效的相关因素。方法2000年3月～2005年6月收治单纯性骨囊肿患儿并获随访31例，男18例，女13例。年龄5岁7个月～15岁，平均9岁6个月。肱骨近端18例，股骨近端7例，肱骨干2例，腓骨近端、股骨远端、胫骨远端及跟骨各1例。活动期13例，静止期18例。其中植骨术后复发2例，类固醇注射5次未愈合1例。合并病理性骨折19例。患儿均先抽去囊液后，注入从髂后上棘吸取的骨髓，平均注入骨髓40ml（30～70m1）。结果术中及术后无并发症发生。31例获随访1～5年，平均2．2年。经1次注射后囊腔完全愈合9例，占29．0％；基本愈合7例，占22．6％；部分愈合5例，占16．1％；未愈合8例，占25．8％；无效2例，占6．5％。骨囊肿静止期与活动期疗效差异有统计学意义（P〈0．05）；5～8岁年龄段与9～15岁年龄段、骨髓增生活跃组与增生明显活跃组、肱骨近端病灶与股骨近端疗效比较，差异均无统计学意义（P〉0．05）。结论经皮注射自体骨髓治疗单纯性骨囊肿安全、有效，但1次注射疗效有限，部分需多次注射；静止期疗效优于活动期。Objective To evaluate the therapeutic results of percutaneous injection of autogeous bone marrow for simple bone cyst and to analyze the prognostic factors of the treatment. Methods From March 2000 to June 2005, 31 patients with simple bone cysts were treated by percutaneous injection of autogeous bone marrow. Of 31 patients, there were 18 males and 13 females, aged 5 years and 7 months to 15 years. The locations were proximal humerus in 18 cases , proximal femur in 7 cases and other sites in 6 cases. Two cases were treated with repeated injections. The operative process included percutaneous aspiration of fluid in the bone cysts and injection of autogenous bone marrow aspirated from posterior superior iliac spine. The mean volume of marrow injected was 40 ml（30-70 ml）. Results No complications were noted during treatment. Thirty patients were followed for an average of 2.2 years（1-5 years） with 2 cases out of follow-up. After one injection of bone marrow, 9 cysts （29.0%） were healed up completely, 7 cysts （22.6%）basically healed up,13 cysts （41.9%）healed up partially and 2 （6.5%） had no response. The satisfactory and effective rates were 67. 7% and 93. 5% respectively. There was significant difference between active stage group and resting stage group （P〈0.05）. There were no statistically significant difference in therapeutic results between groups of different ages, lesion sites or bone marrow hyperplasia （P〉 0. 05）. Conclusion Percutaneous injection of autogeous bone marrow is a safe and effective method to treat simple bone cyst, but repeated injections is necessary for some patients. The therapeutic results are better in cysts at resting stage than those at active stage.

关 键 词：单纯性骨囊肿 自体骨髓 经皮注射 

分 类 号：R681[医药卫生—骨科学]