原发动脉瘤样骨囊肿117例临床回顾分析  

A clinical retrospective analysis on 117 cases of primary aneurysmal bone cyst

作　　者：孙扬[1] 牛晓辉[1] 王涛[1] 张清[1] 丁易[1] 郝林[1] 

机构地区：[1]北京积水潭医院骨肿瘤科,北京100035

出　　处：《中国骨与关节外科》2013年第3期204-208,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:刮除植骨是原发动脉瘤样骨囊肿的主要治疗方式,其他治疗方式如切除、激素注射、栓塞也见诸报道,均可获得较为满意的治愈率。目的:回顾性分析117例原发动脉瘤样骨囊肿的流行病学特点及影响其复发的相关因素,探讨原发动脉瘤样骨囊肿的治疗方案。方法:1993年2月至2011年5月共收治原发动脉瘤样骨囊肿117例,男68例,女49例;年龄7～60岁,平均23.1岁,中位年龄21岁;病变主要位于股骨、胫骨、脊柱、骨盆及肱骨。治疗手段主要为病灶刮除,还包括局部切除、激素注射、栓塞、放疗、单纯内固定。结果:1年以上随访期77例,随访时间为12～176个月,平均36个月。7例复发,术后复发时间为6～102个月,中位术后复发时间为20个月,复发率为9.1%。复发病例均为病灶刮除患者,其中骨盆3例,股骨4例。初始行非手术治疗8例,其中6例可见病变修复。结论:病灶刮除仍是原发动脉瘤样骨囊肿的主要治疗手段,骨盆病变及复发病变接受治疗后的复发风险较大,对病变部位手术难度大或术后肢体功能影响较大的病变可试行非手术治疗,合理的治疗方案选择有助于控制复发率并保留肢体功能。Background：Grafting bone curettage is the most widely accepted treatment for the primary aneurysmal bone cyst（ABC）.Other treatments such as resection,steroid injection,and embolization can also be found in the literature.All these treatments can achieve satisfactory cure rates.Objective：To retrospectively analyze the epidemiological characteristics and recurrence factors of the primary aneurysmal bone cyst on 117 cases,and investigate the therapeutic regimen for this disease.Methods：From February 1993 to May 2011,117 patients,68 males and 49 females,with primary aneurysmal bone cysts were treated in the Department of Orthopedic Oncology.Aged from 7 to 60,they had a mean age of 23.1 years old and a median age of 21 years old.The lesions were principally located in the femur,tibia,spine,pelvis and humerus.The mainstay of treatment was lesion curettage,and other options included were local resection,steroid injection,embolization,radiotherapy,and simple internal fixation.Results：77 patients were followed up for more than 12 months,the average follow-up period was 36（12-176） months.7 out of the 77 patients experienced recurrence at a median period of 20（6-102） months after the operation,the recurrence rate was 9.1%.All the recurrences were found in the curettage group,3 were located in the pelvis and 4 were located in the femur.Eight patients received the non-operation treatment from the beginning and 6 of them achieved lesions healing.Conclusions：Lesion curettage is the main method for treating the primary aneurysmal bone cysts.Pelvic lesion and recurrent cases have a comparatively high risk of recurrence after the treatment.Non-operation treatment can be considered when the surgery is difficult to perform or has significant impact on the limb function.Reasonable treatment options can help control the recurrence rate and reserve the limb function.

关 键 词：动脉瘤样骨囊肿 复发因素 治疗 

分 类 号：R738.1[医药卫生—肿瘤]