胫骨造釉细胞瘤手术方法选择  

Choice of surgical technique for treatment of tibial ameloblastoma

作　　者：朱明海[1] 梁国辉[1] 张颖[1] 冯峰[1] 张天健[1] 

机构地区：[1]洛阳正骨医院正骨研究所,河南洛阳471002

出　　处：《中国骨伤》2006年第8期484-486,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的：探讨胫骨造釉细胞瘤手术方法选择的应用价值。方法：胫骨造釉细胞瘤患者5例，男4例，女1例；年龄14～61岁，平均37．8岁。5例行手术治疗，先后多次复发。早期行病灶刮除、自体骨、异体骨或人工骨植骨术，全部复发。复发后又先后行瘤段切除、自体游离腓骨移植术，瘤段切除、异体骨移植术。最终4例行截肢术。结果：术后随访10个月～3年，平均12．4个月。病灶刮除植骨术后复发5例，3例再行瘤段切除、自体游离腓骨髂骨移植术，其中2例复发；2例再行瘤段切除、异体骨移植术，均复发。复发的4例均采取截肢治疗。出现肺转移1例，行肺转移灶切除术；出现骨转移1例，行髋关节离断术，随访末期死亡0例。结论：虽然胫骨造釉细胞瘤有很高的复发率，但经过积极正确的手术方法治疗，预后尚好。Objective：To evaluate the application value of choice of surgical technique for treatment of tibial ameloblastoma. Methods：Five patients （4 male and 1 female; an average age of 37.8 years ranging from 14 to 61 years） with tibial ameloblastoma were treated respectivly by surgical operation and all patients were relapsed for many times. At first 5 patients all underwent focal cleaning and bone grafting with autologous, heterogeneous or artificial bone. After relapsed the patients underwent respectively prothesis by tumor removal and bone grafting with autologous iliac bone or fibula; prothesis by tumor removal and bone grafting with heterogeneous bone. At last 4 patients suffered amputation. Focus removal to metastatic tumor of lung. Results： All the cases were followed-up for an average of 12.4 months （ 10 months to 3 years）. Five patients by focal cleaning and bone grafting all relapsed. Among them 1 case relapsed with prothesis by tumor removal and bone grafting with autologous iliac bone and 2 cases relapsed with prothesis by tumor removal and bone grafting with fibula, 2 of them re-relapsed; 2 cases relapsed with prothesis by tumor removal and bone grafting with heterogeneous bone, all re-relapsed. At final, 4 cases relapsed with amputation. One case was appeared metastatic tumor of lung and operated by focus removal, 1 case were appeared metastatic tumor of bone and operated by hip disarticulation and no dead patient. Conelusion：Ahhough recurrent rate of tibial ameloblastic is high, it has good prognosis after active and right operative therapy.

关 键 词：胫骨 造釉细胞瘤 外科手术 

分 类 号：R738.1[医药卫生—肿瘤]