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目的探讨骨嗜酸性细胞肉芽肿的临床特点及诊疗措施。方法回顾性分析2003年1月-2006年6月本院收治的骨嗜酸性细胞肉芽肿12例(男8例,女4例),查阅病历资料,影像学资料,结合随访复查记录,分析病例发病部位,临床症状、体征及发病特点,分析诊断及治疗方法 ,并参阅有关文献进行分析总结。结果病变单发9例。其中颈椎骨3例,髂骨2例,胸椎、腰椎、股骨及掌骨各1例。多发3例,分别累及腰椎、胸椎1例,股骨、肩胛骨、多处肋骨和颅骨1例,颅骨、股骨、髂骨1例。病变部位多有局部疼痛,颈椎受累时活动受限较显著。胸椎受累有神经系统受损体征。该病影像学检查基本表现为溶骨损害,长骨受累时可见骨膜反应。累及椎体可表现为扁平椎体,为特征性表现。椎骨外病变病检确诊,椎骨病变用排除法结合随访诊断。本组2例自愈,手术刮除3例中1例辅以植骨,余均行化疗。所有病例疗效满意,随访中未见复发。结论骨嗜酸性细胞肉芽肿病变多为单发,椎骨受累并不少见。局部疼痛功能障碍可为主要症状,影像学检查显示溶骨性病变。病检或排除法结合随访可诊断。该病可自愈,治疗采取观察、手术刮除或化疗,疗效满意。
Objective To investigate the clinical features and diagnosis and treatment of bone eosinophilic granuloma. Methods 12 cases (8 males and 4 females) of bone eosinophilic granuloma admitted in our hospital from January 2003 to June 2006 were retrospectively analyzed. The medical records and imaging data were consulted, and the follow-up records were reviewed to analyze the cases Pathogenesis, clinical symptoms, signs and characteristics of the onset, analysis and diagnosis and treatment, and refer to the relevant literature for analysis and summary. Results lesions in 9 cases. There were 3 cases of cervical vertebrae, 2 cases of ilium, 1 case of thoracic spine, lumbar spine, femur and metacarpal. Multiple in 3 cases, involving the lumbar spine, thoracic 1 case, femur, scapula, multiple ribs and skull in 1 case, skull, femur, ilium in 1 case. Local lesions and more local pain, cervical involvement affected activities significantly more significant. Thoracic involvement has impaired nervous system signs. The basic performance of the imaging examination for osteolytic lesions, long bone involvement can be seen periosteal reaction. Involved in the vertebral body can be expressed as flat vertebral body, is characterized by performance. Vertebral disease pathology diagnosis, vertebral disease with exclusion method combined with follow-up diagnosis. The group 2 cases of self-healing, surgical curettage in 3 cases in 1 case supplemented by bone graft, more than the line of chemotherapy. Satisfactory efficacy in all cases, no recurrence during follow-up. Conclusion Bone eosinophilic granuloma lesions are mostly single, vertebral involvement is not uncommon. Local pain dysfunction can be the main symptom, imaging studies show osteolytic lesions. Disease examination or exclusion method combined with follow-up can be diagnosed. The disease can be self-healing, treatment to observe, curettage or chemotherapy, the effect is satisfactory.