特制假体在骨肿瘤保肢治疗中的应用  

The application of special prosthesis replacement in limb salvage treatment of bone tumors

作　　者：郭世炳[1] 冯卫[1] 郭晓秀[1] 贾燕飞[1] 

机构地区：[1]内蒙古医学院第二附属医院骨肿瘤科,呼和浩特010030

出　　处：《中国医师进修杂志》2007年第11期7-10,共4页Chinese Journal of Postgraduates of Medicine

基　　金：内蒙古自治区卫生厅资助项目（内卫2001-8）

摘　　要：目的探讨特制假体在骨肿瘤保肢治疗中的应用效果。方法在对33例骨肿瘤（恶性10例，良性23例）患者进行特制假体置换中，半肩关节4例；全肘关节2例；髋骨体骨巨细胞瘤切除全髋关节置换术2例；股骨上段单纯股骨头假体4例；股骨中段1例、股骨远端16例和胫骨近端4例分别用加长股骨型、股骨型和胫骨型旋转非限制性轴心式膝关节置换，假体柄用骨水泥在骨干残端髓腔内固定。结果平均随访42个月（6～50个月），除l例髋骨体骨巨细胞瘤、2例滑膜肉瘤、1例恶性纤维组织细胞瘤患者死于肺转移外，余无局部复发和转移，无骨折及假体松动。1SOLS综合评分：上肢优良率80．0％；下肢优良率86．4％。肩关节疼痛缓解率为75％，主动活动增加；髋关节活动基本正常；膝关节屈伸活动0°～100°。结论特制假体置换对骨肿瘤切除后保全肢体、提高患者生存质量是一种疗效可靠的手术方法。Objective To evaluate the effects of special prosthesis in limb salvage treatment of bone tumors. Methods Thirty-three cases of bone tumors （malignancy 10 cases, benign 23 cases） were replaced by special prosthesis. Four cases with unconstrained hemi-arthroplasty, 2 cases with elbow prosthesis, 2 cases with hip prosthesis in giant cell tumor of innominate bone,4 cases with femoral head prosthesis in proximal femoral, 1 case with knee prosthesis of medialis femoral, 16 cases with knee prosthesis of distal femoral and 4 cases with knee prosthesis in proximal tibia were used the longer-femoral,femoral,tibia type revolved unconstrained core knee prosthesis, the handles were fixed with cement into medullary cavity. Results The patients received a follow-up for a mean of 42 months （ranged 6-50 months）, 1 case with hip bone giant cell tumor of bone, 2 cases with malignant synovioma, 1 case with malignant fibrous histiocytoma died of pulmonary metastasis, others were no part recurrence and metastasis, no bone fracture and prosthesis cinch. The rate of the excellent or good was 80.0%（upper extremities）and 86.4%（lower hmbs） according to the ISOLS score. Pain was relieved in 75% patients and active range of motion increased after surgery, in the main, the function of hip joint were normal, the extension and flexion spheres of knee activity were respectively 0°-100°. Conclusion Special prosthesis in treatment of bone tumor is a satisfactory and safe technique.

关 键 词：特制假体 置换 骨巨细胞瘤 骨肉瘤 

分 类 号：R73[医药卫生—肿瘤]