儿童四肢长骨良性骨肿瘤发生病理性骨折的危险因素分析  

Analysis on risk factors for pathological fractures in benign bone tumors of long bones of limbs in children

作　　者：牛小芬 叶文松[1] 李海冰 NIU Xiaofen;YE Wensong;LI Haibing(epartment of Pediatric Orthopedics,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院小儿骨科,杭州310052

出　　处：《浙江医学》2025年第3期285-289,共5页Zhejiang Medical Journal

摘　　要：目的探讨儿童四肢长骨良性骨肿瘤发生病理性骨折的危险因素。方法回顾性选取2015年1月至2023年12月浙江大学医学院附属儿童医院收治的96例四肢长骨良性骨肿瘤患儿为研究对象,根据是否发生病理性骨折分为骨折组40例和非骨折组56例。收集两组患儿性别、年龄、病理诊断等基本信息,通过X线检查评估肿瘤的位置(上肢和下肢)、性质(成骨型、溶骨型和混合型)和范围(包括横轴受损皮质长度/横径和纵轴受损皮质长度);根据疼痛评估记录表进行疼痛评分。比较两组患儿性别、年龄、病理诊断、肿瘤位置、肿瘤性质、肿瘤范围和疼痛程度的差异。采用多因素logistic回归分析儿童四肢长骨良性骨肿瘤发生病理性骨折的危险因素。结果两组患儿性别、年龄、病理诊断、肿瘤位置比较,差异均无统计学意义(均P>0.05);而两组患儿肿瘤性质、横轴受损皮质长度/横径、纵轴受损皮质长度和疼痛程度比较,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示肿瘤呈溶骨型改变、横轴受损皮质长度/横径>2/3、纵轴受损皮质长度>30 mm、重度疼痛是儿童四肢长度良性骨肿瘤病理性骨折的危险因素(均P<0.05)。结论儿童四肢长骨良性骨肿瘤呈溶骨型改变、疼痛明显、肿瘤范围大者发生病理性骨折风险高,早期识别这些危险因素有助于对病理性骨折的预防。Objective To investigate the risk factors for pathological fractures in benign bone tumors of long bone of limbs in children.Methods A total of 96 children with benign bone tumors of long bones of limbs admitted to Children's Hospital,Zhejiang University School of Medicine,from January 2015 to December 2023 were retrospectively selected as the study objects.The patients were divided into fracture group(40 cases)and non-fracture group(56 cases)according to whether pathological fracture occurred.Basic information such as age,gender,pathological diagnosis of the children in the two groups was collected respectively.The location(upper or lower limbs),type(osteogenic,osteolytic,and mixed),and size(including length/diameter of transverse axis damaged cortex and longitudinal axis damaged cortical length)of the tumors were evaluated by X-ray examination.The pain degree was evaluated according to the pain score sheet.The differences of gender,age,pathological diagnosis,tumor location,tumor type,tumor size and pain degree were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for pathological fractures in children with benign bone tumors of long bones of limbs.Results There were no significant differences in age,sex,pathological diagnosis and tumor location between the ftwo groups(all P>0.05),but there were significant differences in tumor type,pain degree,length/diameter of transverse axis damaged cortex and longitudinal axis damaged cortical length(all P<0.05).Multivariate logistic regression analysis showed that osteolytic change,length/diameter of the transverse axis damaged cortex>2/3,longitudinal axis damaged cortical length>30 mm,and severe pain were risk factors for pathological fractures in benign bone tumors of long bones of limbs in children(all P<0.05).Conclusion Benign bone tumors of long bones of limbs in children with osteolytic changes,high pain degree,and large tumor size have a high risk of pathological fractures.Early identification of these risk factor

关 键 词：四肢长骨 病理性骨折 良性骨肿瘤 儿童 

分 类 号：R73[医药卫生—肿瘤]