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目的评价弹性髓内钉治疗肱骨骨囊肿的疗效,探讨影响疗效的相关因素。方法 2009年1月至2012年12月,我院收治肱骨骨囊肿患儿29例,其中男21例,女8例,左侧15例,右侧14例,23例伴发病理性骨折。治疗年龄平均8.7岁,全部患者术前均行肱骨X线、CT和MRI检查。治疗方法采用切开手术证实为单纯性骨囊肿之后,行骨囊肿弹性髓内钉留置术。采用Capanna骨囊肿评价标准。采用χ2检验进行组间疗效比较。结果 29例中26例获得随访,随访时间平均为34个月,按Capanna的骨囊肿评价标准,其中7例治愈,10例愈合但残留病灶,6例提示复发,3例对治疗无反应。有效为17例,总体有效率为65.4%。χ2检验提示其与刮除植骨方法、类固醇注射方法和自体骨髓注射方法之间差异无统计学意义,与弹性髓内钉方法结果之间比较差异有统计学意义(P<0.05)。结论采用弹性髓内钉治疗肱骨骨囊肿,安全、操作方便,但短期疗效并不优于其它治疗方法,没有明确的因素影响骨囊肿的疗效。
Objective To evaluate the efficacy of elastic intramedullary nails in the treatment of humeral bone cysts and to explore the factors that influence the curative effect. Methods From January 2009 to December 2012, 29 children with humeral bone cysts were treated in our hospital, including 21 males and 8 females, 15 on the left, 14 on the right, and 23 with pathologic fractures. The average age of treatment was 8.7 years. All patients underwent humerus humerus, CT and MRI before operation. Treatment of open incision proved to be simple bone cysts, bone cyst elastic nailing surgery. Capanna bone cyst evaluation criteria. Χ2 test was used to compare the efficacy of the two groups. Results Twenty-six of 29 patients were followed up for an average of 34 months. According to Capanna’s evaluation criteria for bone cysts, 7 were cured, 10 were healed but residual lesions were found, 6 were recurred and 3 were unresponsive to treatment. Effective in 17 cases, the overall effective rate was 65.4%. There was no significant difference between χ2 test and curettage and bone graft method, steroid injection and autologous bone marrow injection. There was significant difference between them (P <0.05) and elastic nail method. Conclusions The elastic intramedullary nailing for the treatment of humeral bone cyst is safe and easy to operate. However, the short-term curative effect is not superior to other treatments. There are no definite factors that influence the efficacy of the cyst.