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目的探讨不同手术方法治疗骨巨细胞瘤的临床疗效。方法回顾分析2003年8月～2008年9月手术治疗的39例骨巨细胞瘤。结果全部病例均获得随访,随访时间6个月至5年,平均4.1年。病灶刮除植骨8例,肿瘤复发2例;病灶刮除骨水泥填充18例,肿瘤复发3例;单纯瘤段切除8例,肿瘤复发1例;瘤段切除关节融合3例,肿瘤复发0例;瘤段切除人工假体置换2例,肿瘤复发0例。病灶刮除术治疗Ⅲ期患者2例,肿瘤复发1例;瘤段切除术治疗Ⅲ期患者7例,肿瘤复发1例。病灶刮除组总复发率19.2%,瘤段切除总复发率为7.7%。总体治疗满意率82.0%,不满意率18.0%。结论病灶刮除要达到边缘切除的外科边界,骨水泥填充有较满意的效果;瘤段切除术是治疗骨巨细胞瘤Ⅲ期的可靠方法。
Objective To investigate the clinical effects of different surgical methods in treatment of giant cell tumor of bone. Methods Retrospective analysis of 39 cases of giant cell tumor of the bone treated surgically from August 2003 to September 2008. Results All cases were followed up for 6 months to 5 years with an average of 4.1 years. Eight cases were treated with curettage and curettage, two cases were tumor recurrence, 18 cases were treated with curettage and bone cement implantation, three cases were tumor recurrence, eight cases were resected by simple tumor resection, one case was tumor recurrence, three cases were resected by tumor resection, Cases; tumor resection prosthesis replacement in 2 cases, 0 cases of tumor recurrence. There were 2 cases of stage Ⅲ and 1 case of tumor recurrence after curettage, 7 cases of stage Ⅲ and 1 case of tumor recurrence. The curettage group had a total recurrence rate of 19.2% and a total tumor resection rate of 7.7%. Overall treatment satisfaction rate of 82.0%, unsatisfactory rate of 18.0%. Conclusion The curettage of the lesion should reach the margin of excision and the satisfactory effect of bone cement filling. Tumor resection is a reliable method for the treatment of stage III giant cell tumor.