髋关节复合重建术治疗髋臼周围肿瘤的临床观察  

Composite reconstruction plus hip arthroplasty in the treatment of periacetabular tumor

作　　者：陆萌[1] 吴苏稼[1] 施鑫[1] 周光新[1] 黎承军[1] 赵建宁[1] 

机构地区：[1]第二军医大学南京临床医学院南京军区南京总医院骨科,南京210002

出　　处：《临床肿瘤学杂志》2014年第5期446-448,共3页Chinese Clinical Oncology

摘　　要：目的：分析髋臼周围肿瘤切除联合髋关节复合重建术的疗效，为髋臼周围肿瘤的治疗提供临床依据。方法2001年5月至2010年5月收治24例髋臼周围肿瘤患者，完全切除肿瘤后采用人工全髋关节加重建钢板、螺钉、钢丝和骨水泥复合重建髋关节，术后对患者进行随访。按照骨与软组织肿瘤协会（ MSTS）功能评估标准进行功能评估。结果24例患者中有1例术中突发双侧肺动脉栓塞死亡，其余均顺利完成手术。23例患者术后4～6个月均能基本正常行走，其中11例髋关节功能正常，10例髋关节屈曲功能获部分恢复。5例伤口愈合延迟，均经换药后愈合；2例术后出现腓总神经损伤，1例术后半年恢复；1例在随访时仍未恢复，采用支具保护。随访12～84个月，中位随访40.0个月，随访率为100.0％；死亡2例，复发4例（2例已死亡），21例生存（13例无瘤生存，8例带瘤生存）。 MSTS评分为（23.8±9.2）分，优良率达87.0％（20／23）。结论髋关节复合重建术治疗的患者短期随访可获较好的髋关节功能，同时髋关节复合重建术操作较为简单且费用低，适用范围较广。Objective To investigate the clinical effects of hip arthroplasty plus composite reconstruction for periacetabular tumors. Methods The hip joint was reconstructed with total artificial hip, reconstruction plate, screws, wire and bone cement. The patients were followed up postoperatively. The functional assessment was conducted with the Musculoskeletal Tumor Society Rating Scale（ MSTS） . Results Despite of 1 patient with sudden death due to bilateral pulmonary embolism, the rest were successfully opera-ted. Twenty-three patients could basically walk properly with 11 cases of normal hip function and 10 cases of hip flexion function par-tially restored. There were 5 patients of delayed wound healing. Out of 2 patients with peroneal nerve injure, one got recovery at 6th month postoperative and one did not restore during the follow-up with the use of protective brace. The follow-up ranged 12 to 84 months with the median of 40.0 month and the follow-up rate reached 100.0%. Two patients died and four recurred（ 2 patients died） , while 21 patients survived（13 cases of tumor-free survival, 8 cases survived with tumor）. The MSTS score was（23.8±9.2） with excellent rate of 87.0%（ 20/23） . Conclusion The hip function was good in patients with periacetabular tumors after hip arthroplasty plus composite reconstruction during short-time follow-up.

关 键 词：髋臼周围肿瘤 复合重建 髋关节 

分 类 号：R738.1[医药卫生—肿瘤]