肘关节松解术前放射治疗异位骨化疗效及影响因素  

Efficacy and prognostic factors of preoperative radiation therapy of elbow arthrolysis

作　　者：蒋静[1] 房彤[1] 陈力[1] 陈怡东[1] 孙保锦[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院放疗科,100038

出　　处：《中华医学杂志》2014年第13期1003-1005,共3页National Medical Journal of China

摘　　要：目的 回顾性分析肘关节松解术前1～4h予以单次大剂量放射治疗对于确诊异位骨化患者的治疗效果及可能的影响因素.方法 回顾性分析北京世纪坛医院2008年10月至2010年9月确诊肘关节严重异位骨化患者43例,术前1～4 h内单次放疗剂量总量（DT）8Gy,之后进行肘关节松解术.对治疗前及末次随访时的肘关节功能进行分级,对相关指标进行统计学分析,评价疗效及影响因素.结果 中位随访时间34个月（23 ～ 46个月）,19例（44.2％）关节活动完全恢复正常,1例无效,1例出现伤口肿胀,其他患者未观察到明显短期或长期放疗反应.整组患者治疗前后肘关节功能分级差异具有统计学意义（Z=-5.899,P=0.000）;Logistic分析显示年龄和确诊距放疗时间对异位骨化治疗的疗效影响差异有统计学意义.结论 术前1 ～4h单次DT 8 Gy的放射治疗肘关节异位骨化安全有效,年龄较大、受伤较轻和确诊HO距放疗时间较长的患者恢复好.Objective To assess the efficacy and prognostic factors of preoperative radiation therapy in patients of elbow arthrolysis.Methods From October 2008 to September 2010,43 patients with heterotopic ossification （HO） history at elbow were studied retrospectively.Radiation therapy was given in single fraction of 8 Gy within 1-4 h pre-operation.The elbow HO classifications at preoperation and the last follow-up were analyzed and their efficacy and related prognostic factors evaluated.Results The median follow-up period was 34 （23.24-46.26） months.The elbow function of 19 （44.2％） cases returned to normal.One case was ineffective.Only one case had vulnus swelling.Graham and Hastings HO classification scores were significantly different between pre-operation and the last follow-up （Z =-5.899,P =0.000）.Logistic analysis showed that age and time between diagnoses and treatment had a significant influence of elbow HO.Conclusion Preoperative radiation therapy of 8 Gy within 1-4 h of elbow arthrolysis is both safe and effective.And greater age,milder wound and longer time between diagnoses and treatment have better outcomes.

关 键 词：骨化 异位性 放射疗法 计算机辅助 肘关节 放射治疗剂量 

分 类 号：R687.3[医药卫生—骨科学]