Xu Taotao,Lyu Minjie,Tang Zidan,et al.Prognostic correlation of proximal femoral unicameral bone cyst in children[J].Journal of Clinical Pediatric Surgery,2025,(04):339-344.[doi:10.3760/cma.j.cn101785-202312029-007]
儿童股骨近端单纯性骨囊肿预后相关因素分析
- Title:
- Prognostic correlation of proximal femoral unicameral bone cyst in children
- Keywords:
- Bone Cysts; Femur; Proximal; Prognosis; Root Cause Analysis; Child
- 摘要:
- 目的 探讨影响儿童股骨近端单纯性骨囊肿(unicameral bone cyst,UBC)预后的相关因素。方法 回顾性分析昆明市儿童医院骨科2016年1月至2022年9月采用弹性髓内针(titanium elastic intramedullary nailing,TEN)持续引流减压治疗的25例股骨近端UBC患儿临床资料,其中15例合并病理性骨折。收集患儿性别、年龄、病变侧别、囊肿性质、囊肿指数、有无病理性骨折、置入TEN数量以及术后定期X线随访情况,采用Capanna标准评价术后愈合情况。将随访过程中出现囊肿部分愈合、复发及无反应者归为预后不良组,囊肿完全愈合者归为预后良好组。从两组性别、年龄、病变侧别、囊肿性质、囊肿指数、病理性骨折情况以及TEN数量等方面,分析儿童股骨近端UBC预后的影响因素。结果 25例均获得随访,随访时间18~80个月,平均随访40个月。至末次随访时,预后良好16例,预后不良9例(7例部分愈合,1例无反应,1例复发)。治疗有效率为92%(23/25)(完全愈合和部分愈合判定为治疗有效)。单因素分析发现,静止性病灶预后更好(P<0.05);囊肿指数越小,预后越好(P<0.05);多因素Logistic回归分析发现,囊肿指数(OR=0.005,95%CI:0.000~0.870)是儿童股骨近端UBC预后的独立影响因素(P<0.05)。结论 儿童股骨近端UBC的预后与囊肿指数有关;囊肿指数越小,预后越好,反之,预后越差。TEN置入持续引流减压是儿童股骨近端UBC的一种有效和安全的治疗选择。
- Abstract:
- Objective To explore the related influencing factors of the prognosis of proximal femoral unicameral bone cyst (UBC) in children.Methods From January 2016 to September 2022,retrospective analysis was performed for the relevant clinical data of 25 children with proximal femoral UBC undergoing continuous drainage and decompression with titanium elastic intramedullary nail (TEN).Among them,15 cases developed concurrent pathological fractures.Gender,age,lesion sideness,cystic nature,cystic index,presence of pathological fractures,number of TEN implants and regular postoperative radiographic follow-ups were recorded.Capanna evaluation criteria were utilized for assessing postoperative healing.Partial healing,recurrence and no response during follow-ups were classified as poor prognosis group while complete healing of cysts good prognosis group.Gender,age,lesion sideness,cystic nature,cystic index,pathological fracture status and TEN quantity were compared.Results Average follow-up period was 40(18-80) months.At the last follow-up,there were 16 cases in good prognosis group (complete healing) and 9 cases in poor prognosis group (7 cases partially healed,1 case no response and 1 case relapsing).Effective rate of treatment was 92%(23/25) (complete/partial healing deemed as effective treatment).Univariate analysis revealed that static lesions healed better (P<0.05); the smaller cystic index,the better healing (P<0.05).Multivariate Logistic regression analysis indicated that cystic index (OR=0.005,95%CI:0.000-0.870) was an independent correlation factor (P<0.05) for healing of proximal femoral UBC in children.Conclusions Healing of proximal femoral UBC in children is correlated with cystic index.The smaller cystic index,the better healing.And conversely,the worse healing.TEN implanting for continuous drainage and decompression is both effective and safe for proximal femoral UBC in children.
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备注/Memo
收稿日期:2023-12-13。
基金项目:昆明市卫生健康委员会卫生科研课题项目(2022-06-02-001)
通讯作者:李论,Email:310137126@qq.com