摘要目的 比较激素注入与病灶刮除、植骨手术治疗儿童原发性动脉瘤样骨囊肿疗效,并分析影响预后的因素.方法 北京积水潭医院小儿骨科收治原发性动脉瘤样骨囊肿患儿共48例.其中,激素注入治疗的患儿25例；病灶刮除、植骨治疗的患儿23例.平均随访时间2～10年,平均(4.60±1.76)年.采用Neer/Cole分级作为评价标准.结果 男女发病比例为1.67:1,发病年龄2～15岁平均(7.77±1.67)岁.激素注入治疗组25例,治愈率68.0％,刮除植骨治疗组23例,治愈率73.9％,两组治愈率差异无统计学意义.坐骨、髋臼周围等不易手术显露部位,均采用多次激素注入治疗,效果良好.年龄、发病部位及Enneking分期,是影响预后的相关因素.结论 激素注入治疗动脉瘤样骨囊肿具有手术创伤小,出血少,合并症轻微,可以反复操作等优点.对于手术难以显露的病变部位(如:坐骨、髋臼周围等),应首选该治疗方法.

abstractsObjective The purpose of this study was to compare the outcome of percutaneous intralesional injection of methyl prednisolone and curettage treatment for aneurysmal bone cyst (ABC).Analysis of the factors which affected the prognosis was performed.Methods This was a retrospective review of 48 children and adolescents with ABC in Beijing Jishuitan Hospital.25 cases were treated with methylprednisolone percutaneous injection,while 23 cases were treated with intralesional curettage and bone graft.The average follow-up time was 4.60 1.76 years.Healing was determined using Neer/Cole 4-grades rating scale.Results The male and female incidence ratio was 1.67:1.The age of onset ranged from 2-15 years old (7.77-1.67 years).The cure rate of steriod injection was 68％ whilst the cure rate of the curettage grafting group was 73.9％.The two groups had no significant statistical difference.Ischial and acetabular ABCs used repeated steroid injections to good effect.Age,anatomical site and Enneking staging were prognostic factors.Conclusions Percutaneous injection of methylprednisolone can be effective in treating ABC.It has minimal trauma,less bleeding,minor complications,and can be repeated.This may be the first choice for ABC treatment for lesions which are difficult to access (e.g.) ischium,acetabular.