髌骨骨巨细胞瘤的外科治疗  

The treatment of giant cell tumors of the patella

作　　者：乔苏迟 肖磊 刘畅[3] 李诚 王志伟 徐卫东 

机构地区：[1]海军军医大学附属长海医院骨科,上海200433 [2]解放军515医院骨科,江苏214400 [3]福州总医院骨科,福建350025

出　　处：《中国骨与关节杂志》2018年第1期33-37,共5页Chinese Journal of Bone and Joint

摘　　要：目的探讨髌骨骨巨细胞瘤的外科治疗方法及临床疗效。方法回顾性分析长海医院骨科2002年2月至2015年6月收治的髌骨骨巨细胞瘤患者,按纳入、排除标准筛选出16例,并分为两组。其中,对照组9例予以单纯刮除植骨术,干预组7例于手术前后分别进行唑来膦酸辅助治疗。比较干预组用药前后变化,比较两组术后骨愈合时间、功能恢复、不良事件发生率等。结果干预组术前用药后CT值、VAS评分及膝关节周径较用药前明显改善(P<0.05)。干预组平均骨愈合时间短于对照组(P<0.05),干预组术后1个月及3个月HSS评分高于对照组(P<0.05),术后6个月HSS评分与对照组相当(P>0.05),两组术后复发率差异无统计学意义(P>0.05)。结论使用刮除植骨联合唑来膦酸综合治疗髌骨骨巨细胞瘤具有临床症状及体征改善明显、骨愈合时间短、术后早期功能恢复更好等优点,其临床疗效显著。Objective To investigate the surgical treatment and clinical effects of in the treatment giant cell tumors of the patella. Methods A retrospective analysis of patients with giant cell tumors of the patella, treated at Department of Orthopedics in Changhai Hospital from February 2002 to June 2015, was conducted. Sixteen cases were screened according to the inclusion criteria and divided into two groups. Nine cases in the control group were treated with simple curettage and bone grafting, while 7 cases in the intervention group were treated with zoledronic acid before and after the operation. Changes before and after the surgery were compared. Bone healing time, functional recovery and incidence of adverse events were compared between the two groups. Results CT value, VAS score and knee circumference in the intervention group were significantly improved after the treatment（ P 0.05）. The average bone healing time of the intervention group was shorter than the control group（ P 0.05）. One and 3 months after the operation, HSS score of the intervention group was higher than that of the control group（ P 0.05）. Six months after the surgery, HSS scores of two groups were similar（ P 0.05）. No significant differences in postoperative recurrence rate existed between the 2 groups（ P 0.05）. Conclusions The use of curettage and bone grafting combined with zoledronic acid in treatment of giant cell tumors of the patellar has the benefits of improved clinical symptoms and signs, shorter bone healing time and better postoperative early functional recovery, with remarkable clinical effects.

关 键 词：髌骨 骨巨细胞瘤 唑来膦酸 

分 类 号：R738.1[医药卫生—肿瘤] R687.3[医药卫生—临床医学]