原位微波灭活+肿瘤假体置换治疗四肢肿瘤的近期临床效果观察(附5例报告)  

Short term clinical results of endoprosthetic replacement with microwave-induced hyperthermia in limb salvage treatment of bone tumors:five-case preliminary report

作　　者：张余[1] 杨小明[1] 张涛[1] 徐亮[1] 柯晋[1] 蓝国波[1] 马立敏[1] 欧阳兰飞[1] 黄华扬[1] 尹庆水[1] 夏虹[1] 

机构地区：[1]广州军区广州总医院骨科医院,510010

出　　处：《中华关节外科杂志（电子版）》2012年第3期2-7,共6页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：全军医学科研"十二五"面上项目(CWS11C268);广东省科技计划项目(2007A060101003;2008A060101004)

摘　　要：目的初步观察原位微波灭活+肿瘤假体置换的近期临床疗效,探讨原位微波灭活+肿瘤假体置换在四肢肿瘤保肢手术中的应用价值。方法 2008年1月～2012年1月采用原位微波灭活+肿瘤假体置换方法治疗四肢近关节肿瘤5例,其中骨肉瘤4例,骨转移瘤1例;4例骨肉瘤Enneking分期:ⅡA期3例,ⅡB期1例。结果平均随访17个月,死亡2例,术后生存期分别为7和29个月,1例骨转移瘤患者术后带瘤生存。无局部复发,无假体周围感染、松动及断裂事件发生。术后6个月以上进行功能评分,优2例,良2例,中1例,Enneking得分平均21分。结论原位微波灭活+肿瘤假体置换在不增加局部复发机会和假体松动等并发症的前提下,可以保留更多骨量,为更多软组织覆盖及远期假体翻修等处置提供更多的机会和选择余地,是一种可行的手术方式,远期效果有待进一步观察。Objective To observe and evaluate the short term clinical results of endoprosthetic replacement with microwave-induced hyperthermia in limb salvage treatment for bone tumors. Methods From Jan. 2008 to Jan. 2012, five patients with bone tumors around the joints（four osteosarcomas and one metastatic bone tumor ） were treated with endoprosthetic replacement with microwave-induced hyperthermia, According to Enneking grading system, three of four osteosarcomas were in stage 11 A and one in stage 11 B. Results The average follow-up time was 17 months. Two patients died and their survival periods were respectively seven and 29 months. The patient with metastatic bone tumor lived with tumor. No local recurrence, endoprosthetic infection, loosening or fracture happened. Six months after surgery, two were excellent, two were good and one was fair. The average score was 21 points according to Enneking system. Conclusions Endoprosthetic replacement with microwave-induced hyperthermia can keep more bone mass and provide more opportunities or choices for more soft tissue cover and further revision without increasing the rate of local recurrence, loosening and other complications. It is a feasible method for limb salvage treatment and its long term effect should be further observed.

关 键 词：骨肿瘤 人工假体 关节置换 微波灭活 保肢术 

分 类 号：R739.96[医药卫生—肿瘤]