摘要
作者于１９９１～１９９４年，共收治曾有过不同程度误诊、误治的恶性骨肿瘤病人２５例，其中７例误诊为良性肿瘤行刮除植骨术或误诊为炎性病变行病灶清除术，５例活检失当，余病人虽诊断明确但未采取系统、有效的方法治疗以至延误保肢手术时机。我们认为：骨肿瘤的诊断应以临床、放射、病理三者结合，避免将一些缺乏典型Ｘ线特点的恶性骨肿瘤误诊为良性肿瘤。缺乏经验的诊断性活检易造成切口肿瘤细胞种植，导致保肢手术困难，应尽量避免术前活检。对一些诊断困难的病例，应由有经验的医生从事慎重、细致的术前活检。在治疗上以手术治疗为主，辅以放疗、化疗及免疫治疗等。为避免恶性骨肿瘤的误诊误治。
From1991to1994,25casesofprimarymalignantbonetumorsweretransferredfromotherhospitalstothisdepartment.Althecaseshadreceivedunsuitabletreatmentpreviously.Sevencaseshadthelesionsthoroughlycurettedandpackedwithbonechipsonthemisdiagnosisofbenignle-sions,5underwentinadequatebiopsies,andtheothershadnoregularsystemicandefectivetreatmentforalongperiodoftime,sothattheopportunitiesofalimb-salvageprocedurewerelost,althoughthediagnoseswereestablishedcorrectly.Basedontheanalysisofthesecases,theauthorsconcludedthatthecorrectdiagnosisofmalignantbonetumorsshouldbebasedontheclinicfeatures,theroentgeno-graphicfindingsandthepathologicalfindingssothatmisdiagnosisofthelesionscouldbeprevented.Thepre-operativebiopsyshouldbedonewithdiscretionbyexperiencedsurgeons.Thebiopsymustbeadequatewithoutthedangerofseedingtumorcelsinthevincitysoastoprovidetheconditionforalimbsavingprocedureifitisindicated.Inthetreatmentofprimarymalignantbonetumors,surgicalresec-tionofthelesionisthefirstchoice,andadjuvanttherapy,suchaschemotherapy,radiationandim-munotherapycanbeusedinaddition.TheauthorsproposedtheestablishmentofmorethanoneBoneTumorTreatmentCentersacrossthecountrytoadmittransferanceofbonetumorcasesfromhospitalsatthegenerallevel.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1996年第5期309-311,共3页
Chinese Journal of Orthopaedics
关键词
骨肿瘤
误诊
误治
诊断
治疗
MalignantbonetumorsMisdiagnosisMaltreatment
