桡骨远端骨巨细胞瘤微波消融病灶刮除

Microwave ablation and curettage for giant cell tumor in the distal radius

摘要:

[目的]评价桡骨远端骨巨细胞瘤微波消融病灶刮除术的临床疗效和手术适应证。[方法]回顾分析本院桡骨远端骨巨细胞瘤微波消融病灶刮除术治疗的 8 例桡骨远端骨巨细胞瘤患者的临床资料，其中男 2 例，女 6 例，年龄平均（38.0±17.6） 岁，肿瘤直径平均（4.2±0.8）cm，Campanacci 分级 II 级 3 例、III 级 5 例。[结果]所有患者均顺利完成手术，术中无神经、血管损伤等严重并发症。8 例患者随访（64.4±27.7）个月，随时间推移，患者 VAS 评分、DASH 评分均显著减少（P＜0.05），MSTS 评分及腕关节伸-屈、桡偏-尺偏、旋前-旋后 ROM 和手腕握力均显著增加（P＜0.05）。影像学检查术后无病理骨折发生，8 例患者病灶均已清除，末次随访，未见局部复发和肺转移。[结论]微波消融病灶刮除治疗 Campanacci II~III 级桡骨远端骨巨细胞瘤手术安全，初步结果满意。

Abstract:

[Objective] To evaluate the clinical indications and outcomes of microwave ablation and curettage for giant cell tumor in the distal radius. [Methods] A retrospective study was conducted on 8 patients who received microwave ablation and curettage for giant cell tu- mor in the distal radius in our hospital, including 2 males and 6 females, with an average age of (38.0±17.6) years, tumor diameter of (4.2± 0.8) cm, 3 cases of Campanacci grade II and 5 cases of grade III. [Results] All patients had operation performed successfully without serious complications such as nerve and blood vessel injury. With time of follow- up lasted for (64.4±27.7) months, the VAS score for pain and DASH score significantly decreased (P＜0.05), while MSTS scores, wrist extension-flexion, radio-ulnar deviation and pronation-supination range of motion (ROM), as well as wrist grip strength significantly increased (P＜0.05). Radiographically, all the 8 patients had the lesion re- moved completely without pathological fracture postoperatively, and no local recurrence or lung metastasis by the latest follow-up. [Conclu- sion] Microwave ablation and curettage is safe and achieves satisfactory preliminary results for Campanacci grade II~III giant cell tumor of the distal radius.