髋臼转移瘤患者的Mast Quadrant通道下肿瘤刮除联合骨水泥成形术治疗  

The application of Mast Quadrant-assisted curettage plus cementoplasty in the management of metastatic acetabular tumors

作　　者：晏琼 苏佳佳[3] 何思远 雷军[2] 蔡林[2] 邓洲铭[2] YAN Qiong;SU Jia-jia;HE Si-yuan;LEI Jun;CAI Lin;DENG Zhou-ming(Department of Orthopedics,The Second People’s Hospital of Dawu,Dawu,Hubei,432822,China)

机构地区：[1]湖北省大悟县第二人民医院骨科,432822 [2]武汉大学中南医院脊柱骨肿瘤科,湖北430071 [3]湖北省肿瘤医院放射科,430071

出　　处：《中国骨与关节杂志》2022年第1期44-49,共6页Chinese Journal of Bone and Joint

摘　　要：目的报告13例髋臼转移瘤患者的Mast Quadrant通道下肿瘤刮除联合骨水泥成形术治疗效果。方法回顾分析2017年11月至2019年12月,我院收治的13例(15处病灶)髋臼溶骨性转移瘤患者。13例均接受Mast Quadrant通道下的病灶刮除+骨水泥成形术。收集所有患者的一般资料和手术情况,比较术前,术后1、3个月的视觉模拟评分(visual analogue scale,VAS)、行走功能(MSTS)评分和SF-36量表的差异,并记录术后并发症的发生率。结果13例均完成手术治疗,其中女8例,男5例;年龄20~72岁,平均48.62岁;手术时间40~96 min,平均62.69 min;每个病灶的骨水泥填充量5~16 ml,平均9.3 ml;失血量20~200 ml,平均73.03 ml;VAS评分:术前(5.92±1.49),术后1个月(2.38±1.19)、3个月(1.92±0.86);MSTS功能评分:术前为(15.92±3.68),术后1个月(22.38±4.31)、3个月(23.69±4.23);SF-36评分:术前(61.54±9.88),术后1个月(85.15±16.28)、3个月(90.15±10.49)。三者指标的术前与术后1个月、3个月的评分差异均有统计学意义(P<0.05)。所有患者均未发生肺栓塞等严重并发症和骨水泥渗漏,1例出现术后一过性疼痛加重的情况,2例出现术后发热,经对症治疗后,均在术后7天内恢复。结论Mast Quadrant通道下肿瘤刮除联合骨水泥成形术治疗髋臼转移瘤疗效满意,可以有效缓解疼痛,改善行走功能和生活质量,同时并发症少,是一种安全有效的微创治疗方式,后期仍需要大样本的随机对照试验进一步评估其疗效。Objective To investigate the efficacy of Mast Quadrant-assisted curettage plus cementoplasty in the management of metastatic acetabular tumors.Methods From Nov.2017 to Dec.2019,13 patients (15 lesions)with metastatic acetabular tumors were enrolled in this study.All underwent Mast Quadrant-assisted curettage and cementoplasty.Visual Analogue Scale (VAS),Musculoskeletal Tumor Society (MSTS) scores and Short Form 36 Health Survey (SF-36) results were compared preoperatively,1 and 3 months postoperatively.The incidence of postoperative complication were recorded.Results There were 5 males and 8 females,with a mean age of 48.62 years (range:20-72 years).The average surgery time,cement injected per lesion and blood loss were 62.69 min (range:40-96 min),9.3 ml (range:5-16 ml),73.03 ml (range:20-200 ml),respectively.VAS:(5.92±1.49)pre-operation,(2.38±1.19) 1 month post-operation,(1.92±0.86) 3 months post-operation;MSTS:(15.92±3.68)pre-operation,(22.38±4.31) 1 month post-operation,(23.69±4.23) 3 months post-operation;SF-36:(61.54±9.88)pre-operation,(85.15±16.28) 1 month post-operation,(90.15±10.49) 3 months post-operation;significantly improved VAS,MSTS and SF-36 results were observed preoperatively and postoperatively (P < 0.05).Neither pulmonary embolism nor cement leakage was observed.Temporary increase of the preexisting pain was noted in1 patient,and pyrexia in 2 patients.All 3 patients recovered within 7 days postoperatively.Conclusions Mast Quadrant-assisted curettage plus cementoplasty,as a safe and effective minimally invasive treatment,will relieve pain and improve quality of life,while reducing complications.However,large-sample randomized controlled trial and long-term follow-up are needed to validate the results.

关 键 词：髋臼 骨水泥成形术 转移瘤切除术 骨肿瘤 

分 类 号：R738.1[医药卫生—肿瘤]