Vanderschueren Geert M, Taminiau Antoni H M, Obermann Wim R, Bloem Johan L
Department of Radiology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, NL-2300 RC, Leiden, The Netherlands.
Radiology. 2002 Jul;224(1):82-6. doi: 10.1148/radiol.2241011135.
To determine the clinical results in an unselected group of consecutive patients with osteoid osteoma treated with thermocoagulation.
In 97 consecutive patients with clinical and/or radiologic evidence of osteoid osteoma at any location, the clinical symptoms were assessed before and after thermocoagulation with computed tomographic guidance. A good response was defined as disappearance of symptoms that were manifested at presentation and attributed to osteoid osteoma. Clinical assessment was performed prior to discharge; within 2 weeks after the procedure; and at 3, 6, 12, and 24 months follow-up. After 24 months, a postal questionnaire was used for assessment.
The mean clinical follow-up after the only or the last thermocoagulation session was 41 months (range, 5-81 months). Response was good after one session of thermocoagulation in 74 (76%) of 97 patients, and the 95% CI was 68% to 85%. Patients with persistent symptoms did well after repeated thermocoagulation (good response in 10 of 12 patients), but results of repeated thermocoagulation were poor in patients with recurrent symptoms (good response in five of 10). The overall success rate after one or two thermocoagulation procedures combined was 92% (89 of 97 patients), and the 95% CI was 86% to 97%. Complications were observed in two patients.
Percutaneous thermocoagulation is a safe and effective method for treatment of osteoid osteoma at any location. Repeated thermocoagulation is successful in patients with persistent symptoms.
确定在一组未经选择的连续性骨样骨瘤患者中采用热凝治疗的临床效果。
对97例有任何部位骨样骨瘤临床和/或放射学证据的连续性患者，在CT引导下热凝治疗前后评估其临床症状。良好反应定义为就诊时出现且归因于骨样骨瘤的症状消失。在出院前、术后2周内、3、6、12和24个月随访时进行临床评估。24个月后，采用邮寄问卷调查进行评估。
在仅进行一次或最后一次热凝治疗后的平均临床随访时间为41个月（范围5 - 81个月）。97例患者中74例（76%）在一次热凝治疗后反应良好，95%置信区间为68%至85%。症状持续的患者在重复热凝治疗后效果良好（12例患者中有10例反应良好），但症状复发的患者重复热凝治疗效果较差（10例中有5例反应良好）。一或两次热凝治疗联合后的总体成功率为92%（97例患者中有89例），95%置信区间为86%至97%。观察到2例患者出现并发症。
经皮热凝是治疗任何部位骨样骨瘤的一种安全有效的方法。重复热凝治疗对症状持续的患者有效。
