病灶刮除、灭活、骨水泥填充、钢板内固定术治疗骨巨细胞瘤的疗效观察
Observation ofCurative Effect of Lesion Scraping, Inactivation, Bone Cement Filling, and Plate Internal Fixation on Giant Cell Tumor of Bone

目的：观察肿瘤病灶刮除、灭活、骨水泥填充、钢板内固定术治疗股骨远端骨巨细胞瘤的临床疗效。方法：选取我院股骨远端骨巨细胞瘤患者50例作为研究对象，所有研究对象均进行了肿瘤病灶刮除、灭活、骨水泥填充、钢板内固定手术，术前及术后观察影像学资料、膝关节肌力肌、膝关节屈伸、复发率、恶变率情况，验证肿瘤病灶刮除、灭活、骨水泥填充、钢板内固定手术对骨巨细胞瘤患者的优良率情况。结果：术后我们对患者进行了5年随访，从影像学方面观察到肿瘤病灶部位未见肿瘤复发情况，骨水泥填充完整，钢板内固定物位置良好，无骨水泥脱落、钢板内固定物移位、断裂等情况发生，同时我们发现在术后1月时患者的肌力达到术前肌力相似水平，于术后3月时膝关节主动屈曲活动达到术前相似水平，屈伸活动良好。在我们随访中发现，仅仅有一例患者术后在第3年时复发，复发位置在原手术部位，我们对其进行了股骨远端切除后肿瘤假体定制 + 关节置换术，术后随访至今未见复发，恢复良好。同时，在我们所有手术患者中，我们未发现骨巨细胞瘤术后恶变情况，均恢复良好，优良率达到98%。结论：肿瘤病灶刮除、灭活、骨水泥填充、钢板内固定术治疗股骨远端骨巨细胞瘤具有明显的临床效果，患者能够很好地恢复患肢肌力及膝关节屈伸活动，能够较早地下地活动，同时明显地降低了患者术后的复发率及恶变率，具有很好的优良率，能够很好地改善患者术后生活质量，具有良好的社会及经济利益，值得应用及推广。
Objective: To observe the clinical efficacy of tumor curettage, inactivation, bone cement filling, and plate internal fixation for giant cell tumor of distal femur. Methods: Fifty patients with giant cell tumors of the distal femur of our hospital were selected as the research subjects. All the subjects underwent tumor curettage, inactivation, bone cement filling, and plate internal fixation. Obser-vation of imaging date, knee muscle strength muscles, knee flexion and extensionbefore and after surgery, recurrence rate, and malignancy rate, is to verify theclinical efficacy of tumor curettage, inactivation, bone cement filling, and plate internal fixation for patients with giant cell tumor of bone. Results: After 5 years of follow-up, we observed no tumor recurrence at the tumor site from imaging. The bone cement was completely filled, the position of the plate internal fixation was good, bone cement did not fall off, and the internal fixation of the steel plate did not shift. At the same time, we found that the muscle strength of the patient reached a similar level of preoperative muscle strength at 1 month postoperatively, and the active flexion of the knee joint reached a sim-ilar level before surgery at 3 months postoperatively, and the flexion and extension activities were good. During our follow-up, we found that only one patient had a recurrence at 3 years after surgery, and the recurrence was at the original surgical site. We performed custom-made tumor prosthesis + joint replacement after distal femoral resection, and no recurrence had been observed since the follow-up. At the same time, in all of our surgical patients with giant cell tumor of bone, we did not find malignant changes after postoperative, all recovered well, and the excellent and good rate reached 98%. Conclusion: Tumor lesion scraping, inactivation, bone cement filling, and plate internal fixation have obvious clinical effects in treating giant cell tumor of distal femur. The patient’s