成软骨细胞瘤65例临床分析  

Management of Chondroblastoma:Retrospective Review of 65 Patients

作　　者：郭中帅[1] 刘宇雷[1] 扈鑫 扈文海[1] 

机构地区：[1]河北医科大学第三医院骨肿瘤科,河北石家庄050051

出　　处：《实用骨科杂志》2014年第3期228-231,共4页Journal of Practical Orthopaedics

摘　　要：目的 分析成软骨细胞瘤的特点、治疗方法和疗效.方法收集我院自1994年-2011年经手术病理确诊并有完整随访资料的成软骨细胞瘤共65 例.其中男45 例,女20 例,男女比例为2.25︰1;年龄3～45 岁,平均（18.42±7.94） 岁.病变部位为胫骨近端8 例（12%）,股骨远端11 例（17%）,股骨近端23 例（35%）,肱骨近端和距骨各4 例（6%）,髌骨3 例,跟骨和骨盆各2 例,足舟骨、桡骨近端、桡骨远端、肋骨、肩胛骨、腓骨、股骨干、C7附件各1 例.行单纯病灶内刮除5 例,刮除植骨40 例,刮除骨水泥填充11 例.行瘤段切除9 例（人工关节置换4 例,单纯瘤段切除5 例）.结果平均随访65.3个月（15～200个月）.3 例局部复发,经再次手术治疗无复发.复发率为4.6%.未发现转移者.结论 成软骨细胞瘤影像学诊断易与骨巨细胞瘤等混淆,病灶内刮除术可以达到较好的疗效,在保证患者肢体功能的前提下适度扩大病灶的切除范围可降低其复发率.Objective Analyze the features, the therapy and the curative effect of the chondroblastoma. Methods A retro- spective review was performed with 65 patients who presented to our hospital between 1994 and 2011 with chondroblastoma of bone. They were 45 males and 20 females in this group （ male/female = 2.25 ： 1 ）. They were aged from 3 to 45 years with an average age of （ 18.42 ± 7.94 ）. Tumors were located at proximal tibia in 8 （ 12% ） patients ; distal femurs in 11 （ 17% ） ; proximal femurs in 23（35% ） ,proximal humors and talus in 4（6% ） ,patella in 3 ,calcaneus and pelvis each in 2 ,navicular bone, proximal radius, distal radius, rib, scapula, fibula, femoral diaphysis, C7 appendix each in 1.5 patients had intralesional curettage alone ,40 patients had curettage and bone grafting, 11 patients had curettage and packing the cavity with bone cement. The other 9 patients underwent en-bloc resection（prosthetic replacement 4 cases;Simply en-bloc resection 5 cases）. Results Patients were followed up for the mean duration of 65.3 months （ ranging 15 - 200 months ）. 3 patients had a local recurrence, both resolved after repeat surgeries without further recurrence. The recurrence rate was 4.6%, No patients had metastasis. Con- elusion Chondroblastoma imaging diagnosis is easily confused with giant cell tumor,etc. The Outcomes of intralesional curettage were usually good. On the premise of guarantee the patients limb function, moderately expanding resection of lesions can reduce the recurrence rate.

关 键 词：软骨母细胞瘤 诊断 治疗 复发 

分 类 号：R738.3[医药卫生—肿瘤]