组配式半骨盆假体置换术后早期系统康复训练的临床应用  

Clinical Research of Early Rehabilitation Intervention after Pelvic Reconstruction with Modular Hemipelvic Prostheses

作　　者：陈春雨[1] 罗翼[1] 段宏[1] 罗教明[2] 周勇[1] 闵理[1] 张闻力[1] 屠重棋[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川大学生物材料工程研究中心,成都610064

出　　处：《成都医学院学报》2016年第3期307-312,共6页Journal of Chengdu Medical College

基　　金：四川省卫生厅资助项目(No:2010FZ0088)

摘　　要：目的：探讨髋臼周围肿瘤切除半骨盆假体重建后早期系统康复锻炼的应用及对患者术后功能影响。方法选取2004年1月至2013年1月四川大学华西医院骨科行骨盆肿瘤切除组配式半骨盆假体重建患者共42例，依据MSTS评分标准，测量患者术后1、3、6、12月的术后功能。结果随访时间12～86月，平均随访36月。术后并发症发生率30.95％，髋关节脱位发生率7.14％。术后1、3、6、12月 MSTS 评分分别为14.47、19.71、20.95、21.31分。术后1、3、6月功能逐渐好转，MSTS评分呈递增趋势，3个时间点的MSTS评分比较，差异有统计学意义（P＜0.05）；术后6、12月功能改善不明显，2个时间点的MSTS评分比较，差异无统计学意义（P＞0.05）。结论组配式半骨盆假体治疗骨盆肿瘤疗效满意，术后早期功能恢复至关重要，超过6月后肢体功能改善不明显。Objective To discuss the application and effect of early rehabilitation intervention after pelvic reconstruction with modular hemipelvic prostheses . Methods 42 cases of consecutive patients treated with periacetabular resection and pelvic reconstruction with modular hemipelvic prosthesis from January of 2004 to January of 2013 in West China Hospital of Sichuan University were selected as the research objects , and the postoperative function was measured after 1 month ,3 months ,6 months and 12 months of the surgery respectively according to the functional rating system of Musculoskeletal Tumor Society （MSTS） .Then the variance analysis was used to analyze the correlation between the MSTS scores of the postoperative function and the early rehabilitation .Results The periods of follow‐up visits ranged from 12 months to 86 months ,and the mean is 36 months .The complication rate was 30.95% and the hip dislocation rate was 7.14% .The MSTS scores after 1 month ,3 months ,6 months and 12 months of the surgery were 14.47 ,19.71 ,20.95 and 21.31 respectively .The increase of the MSTS scores in the first 6 months showed significant improvement of the postoperative function ,and there were significant differences among the 3 scores measured in the first 6 months （P〈0.05） ,but no significant differences between the scores measured after 6 and 12 months （P〉0.05） .Conclusion The modular hemipelvic prosthesis is a safe and effective method to treat the pelvic tumor .The early rehabilitation intervention within the first 6 months of the surgery is critical for the function recovery ,which could not be improved significantly after 6 months of the surgery .

关 键 词：骨盆肿瘤 切除 康复训练 功能评价 MSTS评分 

分 类 号：R681[医药卫生—骨科学]