多发性骨软骨瘤的临床特点及外科治疗探讨  

Clinical characteristics and surgical treatment of multiple osteochondromatosis

作　　者：沈阳[1] 王隼[1] 王一臣[1] 陈梦婕[1] 陈柏松[1] Shen Yang;Wang Sun;Wang Yichen;Chen Mengjie;Chen Baisong(Department of Orthopedics,Shanghai Children's Hospital,Shanghai Jiaotong University,Shanghai 200062,China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院骨科,上海200062

出　　处：《中国医学前沿杂志（电子版）》2020年第12期64-67,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2017年上海市卫计委课题(201740087)。

摘　　要：目的分析多发性骨软骨瘤的临床特点,总结多发性骨软骨瘤的外科治疗经验。方法回顾性分析2008年12月至2018年12月上海交通大学附属儿童医院诊治的12例多发性骨软骨瘤患者的临床资料,收集其相关临床资料,分析多发性骨软骨瘤的临床特点、手术处理时机、具体方法和预后。结果12例患者中,病变累及膝关节者最多,占66.67%。4例患者瘤体受累部位超过10处,4例患者因瘤体压迫导致肢体外观畸形。临床分型以Ⅰ型为主,占41.67%。10例患者接受局部瘤体切除术,切除瘤体最大体积为15 cm×11 cm×8 cm,1例患者接受肿瘤切除+尺桡关节重建,1例患者实施肢体矫形。所有患者平均随访3.5年,关节功能得到显著改善,未发现恶变倾向。1例患者复发,其他患者均未发生骨感染、再骨折、血管神经损伤等并发症。结论多发性骨软骨瘤多合并骨骼畸形,以累及膝关节周围居多。对影响关节功能,有恶变征兆,巨大骨软骨瘤,压迫脊髓、神经、血管等的瘤体应尽早手术治疗,手术治疗效果确切。Objective To analyze the clinical characteristics of multiple osteochondromatosis and summarize the experience of surgical treatment of multiple osteochondromatosis.Method The clinical data of 12 patients with multiple osteochondromatosis diagnosed and treated in Shanghai Children's Hospital,Shanghai Jiaotong University from December 2008 to December 2018 were retrospectively analyzed.The clinical data of multiple osteochondromas were collected,and the clinical characteristics,operative time,specific methods and prognosis of multiple osteochondromas were analyzed.Result Among the 12 patients,66.67%of the patients were involved around the knee joint.Four patients involved more than 10 tumor sites,and 4 of patients with tumor compression caused limb appearance deformity.The main clinical type was typeⅠ,accounting for 41.67%.Among the patients,10 patients underwent local tumor resection with the maximum volume of 15 cm×11 cm×8 cm.One patient underwent tumor resection and reconstruction of the radial and ulnar joint,and one patient underwent limb orthopedics.All patients were followed up for an average of 3.5 years,joint function was significantly improved,no malignant tendency was found.One patient recurred,and no complications such as bone infection,refracture,vascular and nerve injury occurred in other patients.Conclusion Multiple osteochondromatosis is often associated with skeletal deformity,and most of them involve around the knee joint.If the joint function is affected,there are signs of malignancy,giant osteochondroma,compression of spinal cord,nerves,blood vessels and other tumors should be treated as soon as possible,and the surgical effect is definite.

关 键 词：多发性骨软骨瘤 临床特点 手术 预后 

分 类 号：R738.1[医药卫生—肿瘤]