弹性髓内钉并病灶刮除混合植骨治疗儿童肱骨骨囊肿  

Elastic intramedullary nail combined curettage and bone grafting for the treatment of humeral bone cysts in children

作　　者：周荣 邬均 郑超[1] 李明[1] ZHOU Rong;WU Jun;ZHENG Chao;LI Ming(Department of Orthopaedics, Key Laboratory of Child Development and Disorders of Ministry of Education, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children＇ s Hospital of Chongqing Medical University, Chongqing, 400014 China)

机构地区：[1]重庆医科大学附属儿童医院骨科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室,重庆400014

出　　处：《第三军医大学学报》2018年第12期1125-1129,共5页Journal of Third Military Medical University

基　　金：国家临床重点专科建设项目(国卫办医函【2013】544)~~

摘　　要：目的探讨弹性髓内钉并病灶刮除混合植骨治疗儿童肱骨骨囊肿的疗效,及病灶活跃性对疗效的影响。方法回顾性分析2008年5月至2017年4月我院收治的儿童肱骨骨囊肿42例,治疗采用弹性髓内钉并病灶刮除混合植骨或单一病灶刮除混合植骨。按Neer标准评价病灶活跃期情况及治疗效果,采用χ2检验比较两组疗效。结果平均随访37.6个月。弹性髓内钉并植骨组22例,其中完全愈合14例,部分愈合7例,复发1例;单一植骨组20例,其中完全愈合9例,部分愈合4例,无反应4例,复发3例。两组的治愈率分别为95.5%(21/22)和65.0%(13/20),(P=0.034)。22个活动期病灶中仅有5个完全愈合,而20个静止期病灶中有18个完全愈合(P<0.01)。结论弹性髓内钉并病灶刮除混合植骨治疗儿童肱骨骨囊肿有较高治愈率;活动期病灶较静止期病灶完全愈合率低;对活动期病灶可选择弹性髓内钉并病灶刮除混合植骨治疗。ObjectiveTo investigate the clinical therapeutic effect of elastic intramedullary nail combined curettage and bone grafting for the treatment of simple humeral bone cysts in children, and the impact of cyst activity level on curative effect. MethodsWe retrospectively analyzed the details of children with simple humeral bone cysts who were treated in our department from May 2008 to April 2017. The children were treated either with elastic intramedullary nail combined curettage and bone grafting, or only with curettage and bone grafting. The modified Neer standards were used to evaluate the activity level and the treatment results. Efficacy was evaluated with Chi-square test. ResultsForty-two cases were included and followed up for average 37.6 months. Among 22 cases treated with elastic intramedullary nail and bone grafting, 14 cases were completely healed, 7 cases were partially healed, and 1 case recurred. The other 20 children were treated only with curettage and bone grafting, in which 9 children were completely healed, 4 children were partially healed, 4 children showed no response and 3 children recurred. The curative rate was 95.5% （21/22） and 65.0 % （13/20）, respectively, P=0.034. There were 5 cases were completely healed in 22 active cysts, but that were 18 cases in 20 latent cysts （P〈0.01）. ConclusionElastic intramedullary nail combined curettage and bone grafting is an effective treatment option for simple bone cysts of the humerus in children, it’s also reasonable for the treatment of active cysts, which have lower completely healed rates than latent cysts.

关 键 词：骨囊肿 弹性髓内钉 植骨 联合治疗 疗效比较 

分 类 号：R181.32[医药卫生—流行病学] R687.3[医药卫生—公共卫生与预防医学]