YE Wei-Hua,MEI Hai-bo,TANG Jin,et al.To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment.[J].Journal of Clinical Pediatric Surgery,2010,9(04):0.
C型臂引导下瘤巢磨除术治疗骨样骨瘤
- Title:
- To describe our technique for performing radiofrequency ablation (RFA) in osteoid osteoma and to evaluate the results of treatment.
- Keywords:
- Buttocks/SU; Osteoma; Osteoid; Therapy
- 摘要:
- 目的 介绍C型臂引导下磨除瘤巢治疗骨样骨瘤的微创方法，评价其治疗效果。 方法 2006年9月至2010年3月收治儿童骨样骨瘤10例,其中股骨干骺端5例，股骨中段2例，肱骨干骺端2例，C6椎板1例；年龄5 ~ 14 岁（平均年龄9.2岁），男性4例，女性6例。采用C型臂引导下瘤巢磨除术，先在欲进针的体表放置克氏针作为标志物，并在皮肤上划出标志线，经C型臂透视确定体表标志与瘤巢间位置后，将克氏针直接插入瘤巢中心。然后经克氏针一侧作2 cm皮肤切口，将直径4 mm环锯式骨活检针套进定位的克氏针，进行顺时针旋转环切瘤巢。再用外径6 mm的空心钻徐缓削瘤巢。 结果 所有病例的标本经病理学检查证实为骨样骨瘤。平均手术时间为30 min，平均出血量约50 mL，住院时间为6.7 d。患儿治疗后24 h内原有疼痛症状消失。 随访6～36个月（平均8个月），临床症状消失，X线片及CT扫描提示瘤巢消失，硬化骨范围缩小，无应力性骨折发生。结论 C型臂定位下瘤巢磨除术治疗骨样骨瘤是一种安全、有效、创伤小、费用较低的微创手术，适用于多数部位骨样骨瘤的治疗。
- Abstract:
- Objective To describe the C-arm guided mechanical abrasion nidus of osteoid osteoma and observe its the effects. Methods From September 2006 to March 2010, 10 children with limbs osteoid osteoma were treated by this technique and of which were involved in femur metaphysis in 5 cases, middle femur in 2 cases, humerus metaphysis in 2 cases and C6 lamina in 1 case. The mean age of patients was 9.2 years (from 5 years to 14 years old) and 4 patients were males and 6 were females. A precise preoperative diagnosis of the lesion was mandatory, based on clinical findings, standard radiographs, thin-section CT.When C-arm fluoroscopy a guiding needle was inserted into nidus of ostoid osteoma and with assisted small incision along the needle was made, Then the trephine bone biopsy needle was introduced over guidewire and was turned round by clockwise to grinded nidus and the walls of the nidus are burred out for 1 to 2 mm in all directions with abrasion drill. Results All patients were successful treated with this method. Diagnosis of osteoid osteomas was confirmed histologically in all specimens. Pain relief was achieved in all patients within 24 hours and the average hospital stay was 6.7 days, blood loss was 50ml, no wound infections and no stress fracture occurred. Non recurrent was found after the followed up of 6 -24 months (average 8 months). Conclusions The C-arm guided mechanical abrasion nidus of osteoid osteoma is a safe, effective, less invasive, lower cost method and suited for treatment most osteoid osteoma .
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备注/Memo
湖南省儿童医院骨科（长沙市，410007）