论文部分内容阅读
目的：总结青春期及儿童骨巨细胞瘤（ＧｉａｎｔＣｅｌＴｕｍｏｒｏｆＢｏｎｅ，ＧＣＴ）的临床表现、放射学特点及治疗。方法：１４例青春期及儿童ＧＣＴ选自１９５７～１９９５年我科收治的２１６例ＧＣＴ病人，随访２～１２年，总结其临床表现，放射学特点，治疗及随访结果。结果：青春期及儿童ＧＣＴ占全部ＧＣＴ的６５％，１３／１４发生于１５～１８岁，临床表现以疼痛、肿胀为主，并发病理骨折者较成人ＧＣＴ发生率高；放射学改变为溶骨性改变，位于干骺端者较成年组多见。临床分期２期以下（１１／１４），行病灶刮除、５０％氯化锌水溶液烧灼瘤腔壁＋植骨，３期行瘤段切除或截肢，全部病人无复发或转移，功能优良率达９１７％。结论：青春期及儿童ＧＣＴ较多位于干骺端，绝大多数属于临床２期，行刮除＋５０％氯化锌烧灼＋植骨的方法可以达到较理想的疗效
OBJECTIVE: To summarize the clinical manifestations, radiological features, and treatment of giant cell tumor (GCT) in puberty and children. Methods: Fourteen patients with puberty and children with GCT were selected from 216 patients with GCT who were treated in our department from 1957 to 1995. Followed up for 2 to 12 years, their clinical manifestations, radiological characteristics, treatment and follow-up results were summarized. Results: GCT in adolescents and children accounted for 6.5% of all GCTs, 13/14 occurred in 15-18 years, and the clinical manifestations were pain and swelling. The incidence of pathological fractures was higher than that of adult GCT; radiological changes were dissolved. Skeletal changes were more common in the metaphysis than in the adult group. After the clinical stage was less than 2 (11/14), the lesions were scraped, 50% zinc chloride solution was used to cauterize the tumor wall and bone graft, and the third stage was performed with tumor segment resection or amputation. All patients had no recurrence or metastasis, and the excellent function rate reached 917%. Conclusion: GCT in puberty and children are mostly located in the metaphysis, and most of them belong to clinical stage 2. Curettage +50% zinc chloride cauterization + bone graft can achieve ideal results.