论文部分内容阅读
目的 :分析骨原发恶性肿瘤活检术的风险 ,提出降低其风险发生率的可遵循原则。方法 :收集 1989年 1月～ 1998年 6月收治的 2 3 6例曾作活检术的骨原发恶性肿瘤病例 (包括外院活检 2 3例 ) ,回顾分析活检误诊、并发症以及由于活检对患者所造成的不良后果。结果 :活检误诊 3 3例 ( 13 .89% ) ,取材不精确 ,活检组织不能很好反映肿瘤真正组织学特点的有 12例 ( 5 .8% ) ,并发症 2 4例 ( 10 .17% )。由于活检问题对 2 5例 ( 10 .5 9% )患者的治疗造成了影响 ,其中 7例(包括外院活检 5例 )实行了不必要的截肢术、6例延误了决定性手术的时机、4例进行了切除边缘不够需第 2次扩大切除的手术、而另外 8例则选择了不恰当的辅助治疗。结论 :骨原发恶性肿瘤活检术存在很大的风险 ,其发生主要与肿瘤本身和外科医师缺乏经验有关 ,临床活检需持慎重态度。如果某一医院或医生不能对肿瘤作出正确的诊断或缺乏进一步处理的能力 ,最好不要轻率地作活检术 ,而应及时将患者送往肿瘤中心。
Objectives: To analyze the risk of biopsy of primary malignant bone tumors and propose principles that can be followed to reduce the incidence of risk. METHODS: We collected 236 cases of primary malignant bone tumors that had been biopsy from January 1989 to June 1998 (including 23 biopsies in other hospitals). We retrospectively analyzed misdiagnosis and complications of biopsy and biopsy patients. The adverse consequences. RESULTS: Thirty-three cases (13.89%) were misdiagnosed by biopsy. The results were inaccurate. The biopsy tissue did not reflect the true histological characteristics of the tumor in 12 cases (5.8%). Complications in 24 cases (10.17%) ). Since biopsy problems affected the treatment of 25 patients ( 10.59%), 7 of them (including 5 in the external hospital biopsy) performed unnecessary amputations, 6 delayed the timing of definitive surgery, and 4 patients. The excision of the margin was not enough to require the second extended resection of the surgery, while the other eight patients chose inappropriate adjuvant therapy. Conclusion: There is a great risk in biopsy of bone primary malignant tumors. The occurrence of bone biopsy is mainly related to the lack of experience of the tumor itself and surgeons. Clinical biopsy needs to be cautious. If a hospital or doctor can not make a correct diagnosis of the tumor or the ability to lack further treatment, it is best not to perform biopsy lightly, and the patient should be promptly sent to the center of the tumor.