CAJ | 학술논문

目的探讨在影像引导下经皮双针注射甲基泼尼松龙及注射型硫酸钙治疗单房性骨囊肿的方法与疗效.方法回顾性分析2006年10月至2010年8月治疗的单房性骨囊肿患者37例,男26例,女11例;年龄8～22岁,平均13.2岁.股骨近端病变5例,患者均有大腿近端酸痛、跛行等症状;肱骨近端病变32例,其中16例有上臂近端酸痛等症状,余16例无症状.术前均行X线、CT与MR检查.在"C"型臂X线机透视下将两枚穿刺针分别穿入囊腔内的近端与远端,欧乃派克造影确认两针相通,生理盐水反复冲洗后,注入甲基泼尼松龙120 mg及可注射型硫酸钙,直至囊腔完全充填.根据改良Neer X线评级标准对骨囊肿愈合进行评估.结果术后住院1～3d,平均2.3d.术后每个月摄片复查,如连续2个月骨囊腔面积较前不再缩小则再次注射.37例患者中,6例注射2次,31例注射1次.注射后囊肿均愈合.改良Neer X线评级标准对骨囊肿愈合进行评估:术后3个月时随访37例,其中Ⅱ级6例,Ⅲ级8例,Ⅳ级23例;术后6个月时随访31例,其中Ⅱ级2例,Ⅲ级4例,Ⅳ级25例;术后24个月时随访26例,其中Ⅲ级3例,Ⅳ级23例;术后36个月时随访19例,均为Ⅳ级.结论影像引导下经皮穿刺注射甲基泼尼松龙及注射型硫酸钙治疗单房性骨囊肿,具有创伤小、并发症少、术后恢复快等优点.
목적 탐토재영상인도하경피쌍침주사갑기발니송룡급주사형류산개치료단방성골낭종적방법여료효.방법 회고성분석2006년10월지2010년8월치료적단방성골낭종환자37례,남26례,녀11례;년령8～22세,평균13.2세.고골근단병변5례,환자균유대퇴근단산통、파행등증상;굉골근단병변32례,기중16례유상비근단산통등증상,여16례무증상.술전균행X선、CT여MR검사.재"C"형비X선궤투시하장량매천자침분별천입낭강내적근단여원단,구내파극조영학인량침상통,생리염수반복충세후,주입갑기발니송룡120 mg급가주사형류산개,직지낭강완전충전.근거개량Neer X선평급표준대골낭종유합진행평고.결과 술후주원1～3d,평균2.3d.술후매개월섭편복사,여련속2개월골낭강면적교전불재축소칙재차주사.37례환자중,6례주사2차,31례주사1차.주사후낭종균유합.개량Neer X선평급표준대골낭종유합진행평고:술후3개월시수방37례,기중Ⅱ급6례,Ⅲ급8례,Ⅳ급23례;술후6개월시수방31례,기중Ⅱ급2례,Ⅲ급4례,Ⅳ급25례;술후24개월시수방26례,기중Ⅲ급3례,Ⅳ급23례;술후36개월시수방19례,균위Ⅳ급.결론 영상인도하경피천자주사갑기발니송룡급주사형류산개치료단방성골낭종,구유창상소、병발증소、술후회복쾌등우점.
Objective To investigate the methods and therapeutic effects of image-guided percutaneous needle iniection of methylprednisolone and injectable calcium sulfate for simple bone cysts.Methods Thirty-seven patients with simple bone cysts from 0ctober 2006 to August 2010 were analysed retrospectively in our hospital,including 26 males and 11 females with the average age of 13.2 years(range,8-22 years).Five cases of proximal femus lesions,with proximal thigh pain,limp and other symptoms.Thirty-two cases of proximal humeral lesions,16 patients had proximal pain and other symptoms of upper arm,the other 16 cases were asymptomatic.Preoperative AP and lateral X-ray.CT and MRl were taken.Under the C-arm X-ray monitor.two needles were inserted into the proximal and distal of cysts respectively,Omnipaque contrast was iniected to confirm the two needles is interlinked,then repeated rinsing with normal saline,then 120 mg methylprednisolone and iniectable calcium sulfate were injected,till the cysts were full up.Patients after treatment were assessed according to modified Neer X-ray criteria.Resuits The average hospitalization was 2.3 days (range.1-3 days).X-ray was reviewed every month,additional injection was performed if bone cysts stopped decreasing for 2 consecutive months,iniection 2 times in 6 eases,and 31 cases were injected only once.After 3 months follow.up 37 cases,according to modified Neer X-ray criteria,6 eases regarded as grade Ⅱ,8 as grade Ⅲ,23 as grade Ⅳ;after 6 months,31 patients were followed up,including 2 cases as grade Ⅱ,4 cases as grade Ⅲ,25 as grade Ⅳ;after 24 months of follow-up 26 cases,3 as grade Ⅲ,23 as grade Ⅳ;after 36 months follow-up,19 cases were all grade Ⅳ.Conclusion Imaging-guided percutaneous iniection of methylprednisolone and inieetable calcium sulfate for simple bone cysts has demonstrated,with less trauma,lower complications incidence and quicker recovery.