肩胛带恶性骨肿瘤切除术后肩关节功能的重建  

Functional Reconstruction of Joint Following Resection of Malignant Bone Tumors around Shoulder Girdle:28 Cases Report

作　　者：游木荣[1] 荆珏华[1] 于秀淳[2] 刘晓平[2] 田大胜[1] 钱军[1] 

机构地区：[1]安徽医科大学第二附属医院骨科,安徽合肥市230601 [2]济南军区总医院骨病科,山东济南市250031

出　　处：《中国康复理论与实践》2010年第5期480-482,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨肩胛带部恶性骨肿瘤的切除分型、保肢治疗的方法及其结果。方法 28例肩胛带部恶性骨肿瘤患者按照Malawer等提出的手术分类方法切除肿瘤,选择不同的方法进行保肢治疗,对患者进行肿瘤学结果评定,切除重建后功能评价。结果 28例患者中,3例失访,25例随访时间9～96个月,平均54个月,局部复发6例,死亡11例,根据Enneking肢体功能评价标准:瘤段切除灭活再植患者平均得分23分,异体骨关节移植患者平均24分,同侧锁骨翻转移植患者平均24分,人工假体置换患者平均26分。肩胛骨部分切除患者平均28.5分,全肩胛骨切除、肱骨头悬吊术患者平均25分。结论肩胛带恶性骨肿瘤可以彻底切除;其保肢方法较多,大部分患者手部功能得以保留,肩关节无痛并有一定功能。Objective To explore the classification,limb salvage strategy and treatmental results following resection of malignant bone tumors around the shoulder girdle.Methods 28 patients with malignant bone tumors of the shoulder girdle underwent a limb-sparing resection according to Malawer＇s surgical classification system of shoulder girdle.Various limb-salvage procedures were performed for all patients.They were evaluated with survival,recrudesce,and metastasis.The function outcome was assesssed with Enneking Function Evaluation System.Results 25 patients were followed-up with a mean time of 54 months （ranged 9～96 months）.6 patients recrudesced,11 patients died.According to Enneking Function Evaluation System,the mean score of the upper extremity was 23 in reimplantation of tumor-bearing bone after alcohol devitalization group,24 in osteoarticular allograft group,24 in free periosteum vascularized clavicle group,26 point in endoprosthesis group,25 in the total scapulectomies and the head of humerus slinging group,28.5 in the partial scapulectomies group respectively.Conclusion The malignant bone tumors around the shoulder girdle can be resected completely.There were a variety of limb-salvage procedures following tumors resection,with which hand function can be preserved in the majority of patients with relieved pain and good function shoulder.

关 键 词：肩胛带 骨肿瘤 切除术 重建 保肢术 

分 类 号：R738.1[医药卫生—肿瘤]