人工肿瘤假体置换治疗肱骨近端恶性骨肿瘤的疗效观察  

Endoprosthetic replacement in the treatment of malignant bone tumor at the proximal humerus

作　　者：孙强[1] 郑雪峰[1] 郑加法[1] 

机构地区：[1]大连大学附属中山医院骨科,大连市116001

出　　处：《中国骨肿瘤骨病》2010年第4期306-308,共3页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨肱骨近端骨肿瘤施行人工肿瘤假体置换的手术适应证、近期疗效。方法 8例可连续随访和评估的肱骨近端骨肿瘤,其中骨巨细胞瘤3例,骨肉瘤4例,恶性纤维组织细胞瘤1例。均采用三角肌胸大肌间隙入路,切除病变组织,重建肩外展及内收功能,并进行早期术后功能锻炼。按Neer评分系统对术后的运动和功能方面进行评估并记录。结果术后平均随访23个月。随访期间无感染、关节松动、关节脱位、假体周围骨折并发症。Neer评分平均为84.3分,>90分2例,80～89分5例,70～79分1例,满意率达87.5%。结论人工肿瘤假体置换治疗肱骨近端骨肿瘤疗效较好,能达到切除肿瘤和保肢目的。由于随访时间短,长期疗效有待观察。Objective To investigate the indications of endoprosthetic replacement for malignant bone tumor at the proximal humerus, and its short-term efficacy. Methods A total of 8 consecutive patients were enrolled into this study. The lesions were bone giant cell tumor （n=3）, osteosarcoma （n=4）, and malignant fibrous histiocytoma （n=1）. The resection was performed by cutting through the gap between the deltoid and the ectopectoralis. The affected tissues were resected, and abduction and adduction of the shoulder were restored. All patients underwent early dirigation. Motion and function of the shoulder were recorded and evaluated according to Neer’s scoring system. Results The mean follow-up was 23 months. No infection, loosening and dislocation of the prosthesis, or fracture around the prosthesis was found. The Neer’s score was 〉90 （n=2）, 80-89 （n=5）, and 70-79 （n=1）, with 84.3 on average. The satisfaction rate was 87.5%. Conclusions The outcomes of endoprosthetic replacement for malignant bone tumor in the proximal humerus are good. The tumor was resected while the extremity is saved. Due to the short period of follow-up, the long-term efficacy is to be observed.

关 键 词：肱骨近端 骨肿瘤 假体 置换 

分 类 号：R738.1[医药卫生—肿瘤]