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style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤是一种起源于软骨细胞的恶性肿瘤，中年发病较多，疼痛和肿胀为主要表现，以外科手术治疗为主，预后与肿瘤的严重程度有关。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">发病率：软骨肉瘤发病率在骨骼系统原发性恶性肿瘤中排名第二，仅次于骨肉瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">好发人群：男性好发，男女比例为2:1，中老年较多见，少数病例发生于儿童和青少年。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">好发年龄：好发于40~70岁，40岁以上的病例占50%以上。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">按肿瘤的病变程度分为：原发性软骨肉瘤和继发性软骨肉瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">按发生部位不同可分为：中央型（髓内型）软骨肉瘤、周围型软骨肉瘤、皮质旁型（骨膜型）软骨肉瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">按组织细胞学特点可分为：普通型软骨肉瘤、去分化软骨肉瘤、间叶型软骨肉瘤、透明细胞型软骨肉瘤、皮质旁软骨肉瘤黏液型软骨肉瘤。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\";text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">依据病理学分化程度不同可分为：I、II、川级。\u003C\u002Fspan>\u003C\u002Fp>","⚕️","2026-08-03",{"key":90,"title":91,"html":92,"icon":93,"updatedAt":88},"Symptoms","症状表现","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤有哪些典型症状？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（1）疼痛：软骨肉瘤常见的症状为疼痛，开始为钝痛，间歇性，逐渐加重。如刺激压迫神经时，可引起放射性疼痛、麻木。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（2）肿胀：局部可扪及缓慢增长的肿块。临近关节时，可引起关节肿胀，活动受限。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">（3）皮肤发红发热：患处皮肤可有红热现象。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","📋",{"key":95,"title":96,"html":97,"icon":98,"updatedAt":88},"causes","病因分析","\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤的病因尚不明确，有研究表明软骨肉瘤的发生可能与染色体异常有关。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">染色体异常：与7号染色体的增多、17p1的异常可能有关。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🧬",{"key":100,"title":101,"html":102,"icon":103,"updatedAt":88},"diagnosis","诊断检查","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">1. 医生如何诊断软骨肉瘤？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">根据患者关节疼痛、肿胀等症状，结合病理组织学检查见软骨表现为分叶状，细胞核变大；X线表现为溶骨性破坏，内有钙化灶可明确诊断。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">2. 软骨肉瘤有哪些相关检查？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（1）体格检查：局部可扪及包块。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（2）影像学检查：\u003C\u002Fspan>\u003C\u002Fp>\u003Cul class=\" list-paddingleft-2\" style=\"list-style-type: disc;\">\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">X线检查\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">：\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">可看到骨质破坏的特殊形态，如骨内扇贝样花边、钙化和骨膜反应。还可见软组织肿块。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">CT检查\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">：\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">显示骨质破坏、细微钙化及软组织改变。也可明确肿瘤在骨内及软组织中的范围。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">磁共振成像检查\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">：\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">在显示肿瘤边界、水肿、软组织侵犯等方面效果最好，但是在显示钙化方面效果较差。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003Cli>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">骨扫描\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">：\u003C\u002Fspan>\u003Cspan style=\"font-size: 15px;\">放射性同位素扫描在中央型软骨肉瘤中，病变部位表现为核浓缩现象，而且同位素聚集的范围不超过肿瘤界限，通过检查可发现隐藏的播散病灶。\u003C\u002Fspan>\u003C\u002Fp>\u003C\u002Fli>\u003C\u002Ful>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（3）病理学检查：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">包括切开活检、穿刺活检两种方法，其中切开活检是特异度最高的确诊方法。肉眼可见软骨肉瘤为不规则圆形或葫芦状肿物，瘤体为蓝白色带有光泽，半透明，或质软分叶状。部分区域胶冻样，可形成囊腔伴钙化、骨化。镜下可见肿瘤组织为排列紊乱、大小不一的软骨细胞和少数黏液细胞。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">3. 软骨肉瘤需要和哪些疾病区别？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤和软骨瘤、骨软骨瘤、骨肉瘤都属于骨肿瘤，需加以鉴别。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（1）软骨瘤：软骨瘤骨皮质完整，瘤内钙化密度较高，无软组织肿块；软骨肉瘤有肿块，即可鉴别。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（2）骨软骨瘤：骨软骨瘤多附着于干骺段的骨性突起，形态多样，软骨帽盖厚者可见肿瘤端部有菜花样钙化阴影；而软骨肉瘤软骨帽增厚更明显，并形成软组织肿块，其内可见多量不规则絮状钙化点，即可鉴别。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（3）骨肉瘤：骨肉瘤具有特征性的肿瘤骨化，骨膜反应显著可与软骨肉瘤相鉴别。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","🩺",{"key":105,"title":106,"html":107,"icon":108,"updatedAt":88},"treatment","治疗方式","\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">1、软骨肉瘤去哪个科室就诊？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">肿瘤科、骨科。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">2、软骨肉瘤该如何治疗？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤以外科手术治疗为主，放化疗均不敏感。去分化和间叶型软骨肉瘤化疗可能有效；部分无法进行手术治疗者，可尝试放疗，控制肿瘤生长、减轻症状。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（1）放射治疗：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">治疗软骨肉瘤的一种辅助疗法，主要适用于高度恶性软骨肉瘤、边界不清肿瘤、不易切除肿瘤、手术未能完全切除肿瘤等。采用放射治疗时若注射增敏剂，可提高软骨肉瘤的治愈率。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">（2）手术治疗：\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">根据分期制定手术方案，部位不同手术方法也不同。低度恶性软骨肉瘤可行广泛或根治性切除及保肢手术；恶性程度高的肿瘤可行截肢或关节离断术。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">3、软骨肉瘤患者的预后如何？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">软骨肉瘤的预后取决于肿瘤的恶性程度与治疗方式。中、低度恶性软骨肉瘤治疗后一般预后良好；高度恶性软骨肉瘤一般预后不佳；若能广泛切除病变组织可提高预后。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">4、软骨肉瘤可能有哪些并发症？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">病理性骨折：当出现骨转移性肿瘤时，可发生病理性骨折，出现疼痛、肿胀、活动受限等症状。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\"> \u003C\u002Fspan>\u003C\u002Fp>\u003Ch3 style=\"text-autospace:ideograph-numeric;\">\u003Cspan style=\"font-size: 15px;\">5、软骨肉瘤会转移吗？\u003C\u002Fspan>\u003C\u002Fh3>\u003Cp style=\"text-autospace:ideograph-numeric;text-align:justify;text-justify:inter-ideograph;\">\u003Cspan style=\"font-size: 15px;\">继发性软骨肉瘤发生转移的周期较长，术后5年以上出现转移者并不少见。\u003C\u002Fspan>\u003C\u002Fp>\u003Cp>\u003Cbr\u002F>\u003C\u002Fp>","💊",{"author":110,"reviewedBy":110,"lastReviewed":110,"datePublished":110,"citations":111,"disclaimer":110},"",[112,114,116,118,120,122,124,126,128],{"title":113},"田伟,荣国威,王满宜.《实用骨科学》[M].北京:人民卫生出版社.2016,2(02):1060-1062",{"title":115},"郝定均，马建生,姚建锋.《简明临床骨科学》[M].北京:人民卫生出版社.2014,9(01):687-690",{"title":117},"郭卫,蔡伯，王臻.《中华骨科学骨肿瘤卷》[M].北京:人民卫生出版社.2010,6(01):250-251",{"title":119},"吴孟超，吴在德.《黄家驷外科学》[M].北京:人民卫生出版社.2008,10(07):3085-3086",{"title":121},"侯树勋.《骨科学》[M].北京:人民卫生出版社.2015,8(01):1274-1276",{"title":123},"赵玉沛，于学忠，于晓初.《骨科诊疗常规》[M].北京:人民卫生出版社.2004,2(02):210-211",{"title":125},"石远凯,孙燕.《临床肿瘤内科手册》[M].北京:人民卫生出版社.2015,4(06):34",{"title":127},"韩淑杰,王强,石建民.《骨科常见疾病护理》[M].北京:人民卫生出版社.2017,11(01):110-116",{"title":129},"郭卫,邵增务,张伟滨.软骨肉瘤临床循证诊疗指南[J].中华骨与关节外科杂志.2018,11(4):302-311.",false,1789384125837]