【摘要】 目的探讨骨巨细胞瘤的X线Campanacci分期以及术式对骨巨细胞瘤手术治疗效果的影响。方法回顾性分析2002年12月～2012年2月本院收治的120例骨巨细胞瘤患者的临床资料,其中,刮除组75例,切除组45例。按X线Campanacci分期Ⅰ期25例,主要术式:刮除术、瘤体切除、瘤体切除人工假体置换、截趾术;Ⅱ期60例,主要术式:病灶刮除术、瘤体切除、瘤段切除铰链膝关节置换术、瘤体切除植骨;Ⅲ期35例,主要术式:病灶刮除、瘤体切除、瘤体切除植骨、瘤段切除人工假体置换、瘤段切除铰链膝关节置换术、截肢术。结果刮除组术后总的复发率为9.3%,高于切除组总的复发率为4.4%,两组比较差异无统计学意义(P>0.05),刮除组的预后比切出组好,差异有统计学意义(P<0.05)。CampanacciⅠ、Ⅱ、Ⅲ期术后的复发率依次为20.0%、5.0%、2.9%;受限率依次为24.0%、6.7%、22.9%。Ⅰ期的术后复发率明显的高于Ⅱ、Ⅲ期,差异有统计学意义(P<0.05),Ⅱ、Ⅲ期差异无统计学意义(P>0.05);Ⅰ期受限率高于Ⅱ期,差异有统计学意义(P<0.05),Ⅱ期受限率低于Ⅲ期,差异有统计学意义(P<0.05),Ⅰ期与Ⅲ期差异无统计学意义(P>0.05)。结论就单纯的切除组或刮除组而言,随着Campanacci分期增高,其复发率是增高的。但是侵袭性高的骨巨细胞瘤选择切除术治疗甚至要优于选择刮除治疗侵袭性低的骨巨细胞瘤。Campanacci分期能够很好的指导临床手术方式的选择,手术方式的选择对骨巨细胞瘤的治疗、预后、复发起着至关重要的作用。更多还原

【Abstract】 Objective To investigate the effect of giant cell tumor of bone X Campanacci staging and operative effect on operation of giant cell tumor of bone. Methods Retrospective analysis of the clinical data of 120 cases of December 2002 to February 2012 in our hospital of giant cell tumor of bone, including curettage group 75 cases, 45 cases resection group. 25 cases of according to Campanacci X stageⅠ, the main operation: curettage, tumor resection, prosthetic replacement, the tumor resection, amputation; 60 cases in stageⅡ, the main operation: curettage, tumor resection, resection of tumor segment hinge knee arthroplasty, tumor resection bone grafting; 35 cases in stageⅢ, the main operation: curettage, tumor resection, tumor resection and bone grafting, tumor resection and prosthesis replacement, tumor segment resection hinge knee arthroplasty, amputation. Results The curettage group after total relapse rate was 9.3%, higher than that of the resection group total relapse rate was 4.4%, the difference between the two groups was not statistically significant (P > 0.05 ), The scraping there was better progosis than the cut group, the difference was statistically significant (P < 0.05). Camapanacci phaseⅠ, Ⅱ, Ⅲ postoperative recurrence rate were 20.0%, 5.0%, 2.9%; restricted rate were 24.0%, 6.7%, 22.9%. Phase Ⅰof the postoperative recurrence rate was significantly higher than that inⅡ,Ⅲ, the difference was statistically significant (P < 0.05 ),Ⅱ,Ⅲ stage no obvious difference was not statistically significant (P > 0.05 ); Ⅰ limited rate was higher than the phase II, the difference was statistically significant (P < 0.05),Ⅱperiod limited rate was lower than the phase III, the difference was statistically significant (P < 0.05), there were no significant differences in stage Ⅰand Ⅲ had no statistical significance (P > 0.05 ). Conclusion Simple excision group or curettage group in terms of as Campanacci installments increased, the recurrence rate is higher. High invasive giant cell tumor choose resection in the treatment or even superior to curettage treatment of lower invasive giant cell tumor of bone. Campanacci installments can be a good guide clinical choice of surgical approach, the choice of surgical treatment of giant cell tumor of bone, prognosis, recurrence plays a vital role.更多还原