股骨近端良性肿瘤及瘤样病变的外科治疗  

Surgical Management of Benign Tumor and Tumor-Like Lesion in Proximal Femur

作　　者：周立宇[1] 杨同其[1] 张志刚[1] 吴贵忠[1] 杨惠林[1] 徐明[1] ZHOU Li-yu YANG Tong-qi ZHANG Zhi-gang WU Gui-zhong YANG Hui-ling XU Ming(Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China)

机构地区：[1]苏州大学附属第一医院骨科,江苏苏州215006

出　　处：《中国血液流变学杂志》2016年第2期202-206,共5页Chinese Journal of Hemorheology

基　　金：江苏省临床医学中心基金（ZX201106）

摘　　要：目的探讨股骨近端良洼肿瘤及瘤样病变的手术切除及骨修复重建方法。方法对2013年01月—2015年06月共收治的35例股骨近端良性肿瘤及瘤样病变的外科治疗及疗效进行回顾性分析，疾病种类主要包括纤维结构不良，单纯性骨囊肿等。给予病灶彻底刮除及植骨，并采用不同的重建方式，其中单纯肿瘤刮除6例，髓内固定4例，髓外固定20例，人工关节置换5例。结果所有患者均获得随访，时间10一32个月，平均20．2个月。患者切口均一期愈合，元感染，未见复发及骨折，未见股骨头囊性变及坏死，无内固定松动失效。末次随访MSTS93评分26～30分，平均28．08分。结论依据股骨近端良性肿瘤及瘤样病变发生的部位、范围、生物学特性、股骨近端的生物力学及全身综合情况选择合适的重建方式，Objective To investigate the effective surgical method of benign tumor and tumor-like lesion in proximal femur. Methods To make retrospective analysis of patients with benign tumor and tumor-like lesion in proximal femur most of which are fibrous dysplasia, simple bone cyst. To give a thorough curettage and bone graft, and use different reconstruction methods, including 6 simple tumor curettage, 4 intrameduUary fixation, 20 internal fixation, 5 artificial joint replacement. Results All the patients were followed up ranged from 10 ~ 32 months, average is 20.2 months. There was no incision infection, no recurrence and fracture, no necrosis of the femoral head and fixation failure. All the patients had MSTS93 scores of more than 26 points at the last follow up. Conclusion On the basis of the site, scope, biological characteristics of the proximal femoral benign tumor and tumor-like lesion, the femur proximal biomechanics and systemic conditions, choose appropriate reconstruction model, in order to decrease the recurrence and prevent pathologic fracture and other complications and improve quality of life.

关 键 词：股骨近端 良性肿瘤及瘤样病变 外科治疗 

分 类 号：R738.1[医药卫生—肿瘤]