骨膜下动脉瘤样骨囊肿的临床特点及外科治疗
投稿时间:2017-07-17  修订日期:2017-08-08  点此下载全文
引用本文:顾庆陟,高兴,陶开亮,王俊江,田征.骨膜下动脉瘤样骨囊肿的临床特点及外科治疗[J].医学研究杂志,2018,47(4):53-56,81
DOI: 10.11969/j.issn.1673-548X.2018.04.014
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作者单位E-mail
顾庆陟 830000 乌鲁木齐, 新疆医科大学第一附属医院骨肿瘤科  
高兴 830000 乌鲁木齐, 新疆医科大学第一附属医院骨肿瘤科  
陶开亮 830000 乌鲁木齐, 新疆医科大学第一附属医院骨肿瘤科  
王俊江 830000 乌鲁木齐, 新疆医科大学第一附属医院骨肿瘤科  
田征 830000 乌鲁木齐, 新疆医科大学第一附属医院骨肿瘤科 369274855@qq.com 
基金项目:新疆维吾尔自治区自然科学基金资助项目(2014211C034号)
中文摘要:目的 探讨骨膜下动脉瘤样骨囊肿的影像学、病理学特点及相关外科治疗。方法 回顾分析笔者医院于2013~2017年期间收住治疗6例经骨科、影像科及病理科共同诊断治疗的骨膜下动脉瘤样骨囊肿患者。男性5例,女性1例,患者年龄18~35岁,平均年龄23.3岁;左侧股骨远端4例,右侧股骨远端2例。1例患者因病变瘤体巨大采用双切口,余患者均采用病变部位正中切口,均采用延病变瘤体基底部完整切除肿瘤、瘤腔灭活术。6例患者均未值骨或用钢板固定。结果 患者X线及CT检查均可见囊状溶骨性改变,病变位于皮质或骨膜下未侵及髓腔,病变部位呈"蜂窝状"改变。MRI可见混杂信号的囊性改变,可见液液平面。本组病例中5例患者术中出血约100ml,1例患者肿瘤巨大术中出血约2000ml,术中无死亡病例,手术时间60~120min,平均90min。患者术后回访均未见复发。结论 骨膜下动脉瘤样骨囊肿是ABC的一种少见类型,临床上罕见。因其未侵及髓腔,故手术时可充分暴露病变部位后,沿瘤体基底部完整剥除病变组织,且术中出血较少,术后复发率较低。
中文关键词:骨膜下  动脉瘤样骨囊肿  外科治疗方法  病理特征  影像学
 
Clinical Characteristics and Surgical Treatment of Subperiosteal Aneurysmal Bone Cyst
Abstract:Objective To explore the imaging and pathology features along with related surgical treatment of subperiosteal aneurysmal bone cyst. Methods Six patients with subperiosteal aneurysmal bone cyst diagnosed and treated jointly by Orthopedic Department, Imaging Department and Pathology Department of our hospital during 2013-2017 were selected for retrospective analysis, of which 5 cases were male and 1 case was female in ages of 18-35, and the average age was 23.3; 4 cases were in left distal femur and 2 cases were in right distal femur. One patient received double incisions due to huge lesion, while others received median incision in diseased region. All patients received complete tumor excision and tumor cavity inactivation along the lesion basilar parts, but no bone grafting or plate fixation was applied to the six cases. Results Cystic osteolytic change could be seen in patients' X ray and CT examinations, and the "cellular" lesion located in cortex or subperiosteal dissection without invading medullary cavity. MRI found osteolytic change with mixed signals and fluid level. 5 cases in this study bled about 100ml while one case bled 2000ml; the operation lasted for 60-120min (90min on average) without death occurred. No relapse emerged in the follow-up visit after operation. Conclusion Subperiosteal aneurysmal bone cyst is a rare type of ABC. Considering that it does not invade medullary cavity, the lesion can be fully exposed after operation to completely strip lesion tissues along tumor basilar parts, whose bleeding during operation is less with low relapse after operation.
keywords:Subperiosteal  Aneurysmal bone cysts  Surgical treatment  Pathological characteristics  Iconography
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