“三明治”技术治疗膝关节骨巨细胞瘤疗效分析  

Analysis of effect of sandwich technique in treatment of giant cell tumor of bone of knee joint

作　　者：陈粲一 蔡善保 方策 任文涛 段文 CHEN Canyi;CAI Shanbao;FANG Ce(Department of Orthopaedics,West District of the First Affiliated Hospital of University of Science and Technology of China(Anhui Province Cancer Hospital),Hefei 230031,China)

机构地区：[1]中国科学技术大学附属第一医院西区(安徽省肿瘤医院)骨科,安徽合肥230031

出　　处：《安徽医学》2021年第5期473-476,共4页Anhui Medical Journal

基　　金：国家自然基金面上项目(项目编号:81372868)。

摘　　要：目的探讨“三明治”技术(扩大刮除、软骨下植骨、骨水泥填充)治疗膝关节骨巨细胞瘤的效果。方法回顾性分析2016年1月至2018年12月在中国科学技术大学附属第一医院西区(安徽省肿瘤医院)治疗的膝关节周围骨巨细胞瘤(GCT)患者63例临床资料,按手术方式不同分为对照组(31例)和观察组(32例),其中对照组采用扩大刮除植骨治疗,观察组采用“三明治”技术治疗。术后门诊每3个月随访1次至术后2年,比较两组患者术后末次随访时骨与软组织肿瘤协会(MSTS)评分、术后膝关节活动度(ROM)及复发情况。结果末次随访时,观察组MSTS评分[(27.23±2.65)分]、ROM[(121.62±11.31)度]均高于对照组,差异均有统计学意义(P<0.05)。末次随访时,观察组复发率(6.25%)低于对照组(25.81%),差异有统计学意义(P<0.05)。结论“三明治”技术是一种良好的膝关节周围骨巨细胞瘤的治疗方法,具有术后复发率低,功能恢复好、活动度优良等优点。Objective To explore the clinical effect of sandwich technique(enlarged curettage,subchondral bone grafting,bone cement filling)in the treatment of giant cell tumor of bone of the knee jointin patients.Methods The clinical data of 63 patients with giant cell tumor of bone aroundthe knee jointwho were treated in the West District of the First Affiliated Hospital of University of Science and Technology of China(Anhui Province Cancer Hospital)from January 2016 to December 2018 were retrospectively analyzed.They were divided into a control group of 31 cases and an observation group of 32 cases according to different surgical methods.The control group was treated with expanded curettage and bone grafting,and the observation group was treated with sandwich technology.The postoperative outpatients were followed-up every three monthsto two years,thenthe MSTS scores,postoperative knee range of motion,and recurrence were compared between the two groups.Results At the last follow-up,the MSTS score(27.23±2.65)and ROM(121.62±11.31)of observation group were higher than the MSTS score(25.57±3.74)and ROM(115.23±9.85)of control group,and the differences were statistically significant(P<0.05).The recurrence rate ofobservation group(6.25%)was lower than that of control group(25.81%),and the difference was statistically significant(P<0.05).Conclusions Sandwich technique is a good treatment method for giant cell tumor of bone around the knee joint.It has the advantages of low recurrence rate,good functional recoveryand good activity.

关 键 词：骨巨细胞瘤 “三明治”技术 骨与软组织肿瘤协会评分 膝关节活动度 术后复发 

分 类 号：R738.1[医药卫生—肿瘤]