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目的探讨在CT引导下经皮旋切关节周围骨样骨瘤的治疗方法。方法2003年2月至12月,共收治11例关节周围小病灶(直径6~11mm,平均8.7mm);其中男性7例,女性4例;年龄14~32岁,平均19.3岁。其中股骨近端6例、髋臼区4例,肱骨头内1例。首先对整个瘤巢采用2mm薄层扫描,选择穿过瘤巢中心的层面,以克氏针钻入,定位瘤巢中心,在套筒保护下用环钻沿导引针将整个瘤巢切除。CT扫描复查确定是否已将整个瘤巢切除,并将所取出组织送病理检查。结果其中9例取出的病变组织经病理证实为骨样骨瘤,1例为纤维组织,1例为结核。被病理证实的9例骨样骨瘤患者手术后次日症状缓解,无明显手术并发症发生。随访8~18个月(平均15.2个月),患者症状完全缓解,无1例复发。结论CT引导下,经皮旋切关节周围骨样骨瘤的治疗方法,简便、安全、恢复快。
Objective To investigate the treatment of peri-osteotomied osteoma by percutaneous excision with CT guided. Methods From February 2003 to December 2003, 11 cases of small lesions around the joint (diameter 6 ~ 11mm, average 8.7mm) were treated. There were 7 males and 4 females, aged from 14 to 32 years (average 19.3 years). There were 6 cases of proximal femur, 4 cases of acetabulum and 1 case of humeral head. First, the entire tumor nests using 2mm thin layer scan, select the level of the center of the nests, drill with Kirschner wire, locate the tumor center, under the protection of the sleeve with a ring drill along the guide needle to remove the entire tumor nests. CT scan review to determine whether the entire neoplasm resection, and the removed tissue sent for pathological examination. Results Among them, 9 cases of pathological changes were proved to be osteoid osteoma by pathology, 1 case was fibrous tissue and 1 case was tuberculosis. Pathologically confirmed in 9 cases of osteoid osteoma patients were relieved the next day after surgery, no significant complications occurred. All the patients were followed up for 8-18 months (average 15.2 months). The symptoms of the patients were completely relieved without any recurrence. Conclusion Under the guidance of CT, percutaneous excision of osteoid osteoma around the joint is simple, safe and rapid.