老年膝部复发性软组织肉瘤术后缺损并关节不稳定的临床诊断及治疗  

Clinical diagnosis and treatment of elderly lap recurrent soft tissue sarcoma and joint instability defects

作　　者：刘世炎 王颖[1] 

机构地区：[1]唐山市人民医院骨科,河北唐山063000

出　　处：《现代肿瘤医学》2016年第7期1119-1122,共4页Journal of Modern Oncology

基　　金：河北省医学科学研究重点课题(编号:20130319)

摘　　要：目的:探讨老年膝部复发性软组织肉瘤术后缺损并关节不稳定的临床诊断和治疗方法。方法:选取2011年5月-2013年5月17例符合条件的膝部复发性软组织肉瘤为研究对象。先进行有效的化疗,然后进行关节囊壁和侧副韧带扩大切除术,对膝周软组织缺损并关节不稳定采用重建侧副韧带和部分关节囊,联合小腿复合宽蒂筋膜皮瓣或腓肠肌内侧头肌皮瓣修复软组织缺损,观察治疗前后在生存时间、生存质量、相关指标等变化。结果:治疗后3个月、6个月、12个月、24个月、24个月以上生存率分别为100%、88.24%、70.59%、47.06%、29.41%。显效率58.82%,有效率23.52%,无效率17.65%。治疗前WOMAC量表总积分为(31.47±3.84)分,治疗后为(20.28±2.47)分,治疗前后比较差异有统计学意义(P<0.05)。另外治疗前后在精力、疼痛、情感、睡眠、社会生活和躯体活动生存质量比较差异均有统计学意义(P<0.05)。结论:重建膝关节稳定性,修复缺损软组织对老年膝部复发性软组织肉瘤患者效果是可靠有效的。Objective： To investigate the clinical diagnosis and treatment of elderly knee surgery recurrent soft tissue sarcoma defects and joint instability. Methods： May 2011- May 2013 17 patients of recurrent knee soft tissue sarcoma were selected and treated by effective chemotherapy,followed by joint and ligament wall extended resection of soft tissue knee defects and joint instability using collateral ligament and partial reconstruction of the joint capsule,joint compound leg wide pedicle flap or medial gastrocnemius muscle flap to repair soft tissue defects. Results： The survival time after treatment,3 months,6 months,12 months,24 months,24 months or more survival rates were100%,88. 24%,70. 59%,47. 06%,29. 41%. Markedly effective rate was 58. 82%,efficiency 23. 52%,17. 65%inefficiency,WOMAC scale total score before treatment was（ 31. 47 ± 3. 84） points after treatment was（ 20. 28 ±2. 47） points（ P 0. 05）. The difference before and after treatment were statistically significant（ P 0. 05） in energy,pain,emotion,sleep,social life and quality of life in physical activity. Conclusion： The reconstruction of knee stability,repair of soft tissue defects of the knee effect of recurrent soft tissue sarcoma elderly patients is reliable and effective.

关 键 词：复发 软组织肉瘤 缺损 关节不稳定 

分 类 号：R739.96[医药卫生—肿瘤]