比较注射型人工骨植骨与甲泼尼松龙注射治疗单纯性骨囊肿的临床效果的研究  

A study comparing the clinical effects of injective artificial bone grafting and methylprednisolone injection in the treatment of simple bone cyst

作　　者：杨勇昆[1] 牛晓辉[1] 刘巍峰[1] YANG Yong-kun;NIU Xiao-hui;LIU Wei-feng(Department of Orthopedic Oncology Surgery,Beijing Jishuitan Hospital,Beijing,100035,China)

机构地区：[1]北京积水潭医院骨肿瘤科,100035

出　　处：《中国骨与关节杂志》2023年第5期345-350,共6页Chinese Journal of Bone and Joint

基　　金：北京市医管局“青苗”计划(QML20200403);北京积水潭医院高层次人才“学科骨干”培养计划(XKGG202108);北京积水潭医院自然基金培育计划(ZR-202104)。

摘　　要：目的 甲泼尼松龙注射可用于单纯性骨囊肿的微创治疗,但存在需多次手术、不能快速提高骨强度和病理骨折等问题。本研究的目的是比较人工骨注射和甲泼尼松龙注射两种治疗方法的临床应用效果,包括围术期特点、手术次数、骨愈合情况、术后功能恢复和并发症等。方法 本研究为回顾性病例对照研究。对2016年至2018年,相同时间段内接受注射人工骨植骨和甲泼尼松龙注射两种治疗方法的单纯性骨囊肿进行比较。根据纳入标准,人工骨注射组26例,甲泼尼松龙注射组17例,两组的性别、年龄、病灶体积和部位分布情况差异无统计学意义。结果 人工骨注射组和甲泼尼松龙注射组的平均手术次数分别为1.1(中位1)次和2.6 (中位3)次,差异有统计学意义(P=0.000)。人工骨初次注射后20例完全愈合(76.9%),5例大部分愈合,1例未愈合。甲泼尼松龙初次注射后4例完全愈合(23.5%),8例大部分愈合,5例未愈合。术后6个月,人工骨注射组和甲泼尼松龙注射组分别有73.1%和29.4%的病例可以完全负重且日常活动不受限制。人工骨注射组有1例因排异反应取出人工骨,共3例在初次注射人工骨后再次手术。甲泼尼松龙注射组有2例注射后骨折,1例伤口延迟愈合,共8例在多次注射甲泼尼松龙后再次其它方式的手术。结论 相对于甲泼尼松龙注射,人工骨注射植骨可以获得更为满意的骨愈合效果,可通过更少的手术次数、在更短的时间内帮助恢复肢体活动和负重,术后并发症发生率较低。Objective Methylprednisolone injection can be used for minimally invasive treatment of simple bone cyst,but there are some problems such as multiple operations,failure of quick bone strength improvement,pathological fracture and so on.The purpose of this study is to compare the clinical effects of artificial bone injection and methylprednisolone injection,including perioperative characteristics,operation times,bone healing,postoperative functional recovery and complications.Methods This was a retrospective case-control study.The simple bone cysts treated with artificial bone injection grafting or methylprednisolone injection in the same period from 2016 to 2018 were compared.According to the enrollment conditions,26 cases were enrolled in the artificial bone injection group and 17 cases in the methylprednisolone injection group.There was no significant difference in gender,age,lesion volume and position distribution between the two groups.Results The average number of operation times of artificial bone injection group and methylprednisolone injection group and were 1.1(median 1)and 2.6(median 3),respectively(P=0.000).After the first injection of artificial bone,20 cases healed completely(76.9%),5 cases healed mostly and 1 case did not heal.After the initial injection of methylprednisolone,4 cases healed completely(23.5%),8 cases healed mostly and 5 cases did not heal.Six months after operation,73.1%and 29.4%of the cases in the artificial bone injection group and methylprednisolone injection group showed fully weight-bearing and unlimited daily activities.In the artificial bone injection group,1 case underwent removal of the artificial bone due to rejection,and a total of 3 cases underwent reoperation after initial injection of artificial bone.In the methylprednisolone injection group,there were 2 cases of fracture after injection and 1 case of delayed wound healing,and 8 cases in total underwent other operations after multiple injections of methylprednisolone.Conclusions Compared with methylprednisolone injection

关 键 词：骨囊肿 硫酸钙 磷酸钙类 

分 类 号：R738.1[医药卫生—肿瘤]