一期瘤段切除钢板固定加骨水泥重建姑息治疗转移性肱骨干肿瘤伴病理性骨折的疗效观察  

Observation on the therapeutic effect of one-stage tumor segment resection with plate fixation combined with bone cement reconstruction in the palliative treatment of metastatic humeral shaft tumor complicated with pathological fractures

作　　者：方剑利[1] 楼红侃[1] 高麟超 许旻鸣 金甬 FANG Jianli;LOU Hongkan;GAO Linchao;XU Minming;JIN Yong(Department of Orthopedics,Ningbo Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University,Ningbo315000,China)

机构地区：[1]浙江中医药大学附属宁波市中医院骨伤科,浙江宁波315000

出　　处：《中国现代医生》2020年第26期93-96,共4页China Modern Doctor

基　　金：宁波市自然基金(2019A610360)。

摘　　要：目的探讨采用一期瘤段切除钢板固定加骨水泥重建姑息治疗转移性肱骨干肿瘤伴病理性骨折的临床疗效。方法收集2012年7月~2017年6月在我院应用一期瘤段切除钢板固定加骨水泥重建方法治疗转移性肱骨干肿瘤伴病理性骨折10例患者;于术前及术后分别使用视觉模拟评分法(VAS)进行疼痛改善程度比较,应用Enneking评分法进行肢体功能评价,以及Kanofsky法进行生活质量评价。结果所有患者获得随访,时间为6~12个月,平均10个月。术后VAS评分较术前明显降低(t=14.307,P<0.05)。Enneking评分结果显示,10例中优1例,良好7例,中2例,优良率达到80%。术后Kanofsky评分较术前明显提高(t=12.445,P<0.05)。结论一期瘤段切除钢板固定加骨水泥重建姑息治疗转移性肱骨干肿瘤伴病理性骨折治疗效果确切,取材方便,手术创伤相对较小,并发症少,可以作为肱骨干转移癌伴病理性骨折手术治疗的一种选择。Objective To investigate the clinical effect of one-stage tumor segment resection with plate fixation combined with bone cement reconstruction in the palliative treatment of metastatic humeral shaft tumor complicated with pathological fractures.Methods From July 2012 to June 2017,a total of 10 patients were selected who underwent one-stage tumor segment resection with plate fixation combined with bone cement reconstruction in the treatment of metastatic humeral shaft tumor complicated with pathological fractures.Before and after surgery,visual analogue scale(VAS)was used to compare the degree of pain improvement.Enneking scoring method was used for the evaluation of limb function,and Kanofsky method was used for the evaluation of quality of life.Results All patients were followed up for 6-12 months,with an average of 10 months.The postoperative VAS score was significantly lower than that before surgery(t=14.307,P<0.05).The results of Enneking score showed that among 10 cases of patients,there were excellent in 1 case,good in 7 cases,and moderate in 2 cases.The excellent and good rate was up to 80%.The Kanofsky score was significantly improved after surgery compared to that before surgery(t=12.445,P<0.05).Conclusion One-stage tumor segment resection with plate fixation combined with bone cement reconstruction in the palliative treatment of metastatic humeral shaft tumor complicated with pathological fractures has an exact therapeutic effect.This method is convenient to collect materials,the surgical trauma is relatively small,and there are few complications.It can be used as an option for surgical treatment of metastatic carcinoma of humeral shaft complicated with pathological fractures.

关 键 词：肱骨干肿瘤 病理性骨折 骨水泥重建 姑息治疗 

分 类 号：R738[医药卫生—肿瘤]