对行可延长假体置换术后的患儿实施神经减张治疗的效果评估  

Evaluation of the effect of nerve tensioning therapy in children after extendable prosthesis replacement

作　　者：程佳佳 黄俊琪 毕文志[2] CHENG Jiajia;HUANG Junqi;BI Wenzhi(Mianyang Central Hospital,Mianyang Hospital affiliated to School of Medicine,University of Electronic Science and Technology of China,Mianyang Sichuan 621000;PLA General Hospital,Beijing 100853)

机构地区：[1]电子科技大学医学院附属绵阳医院,绵阳市中心医院,四川绵阳621000 [2]解放军总医院,北京100853

出　　处：《当代医药论丛》2022年第3期34-37,共4页

基　　金：绵阳市中心医院孵化课题:唑来膦酸抑制骨巨细胞瘤的作用机制研究(2019FH15)。

摘　　要：目的:探讨对接受可延长假体置换术后的骨肉瘤患儿进行神经减张治疗的效果。方法:选择近年来在绵阳市中心医院进行可延长假体置换术的18例骨肉瘤患儿作为研究对象。术后对这些患儿均进行神经减张治疗,然后观察其各项临床指标。结果:术后18例患儿的患肢较术前均延长2 cm。在18例患儿中,术后患侧膝关节屈曲<30°的患儿有5例,术后需保持患侧膝关节屈曲≥30°的患儿有13例(这13例患儿在术后2周左右其患侧膝关节均可完全伸直)。术后这些患儿均未出现严重的并发症,其中有1例患儿出现患肢远端麻木的症状。与术后当天相比,接受1周的神经减张治疗后18例患儿疼痛数字评分法(NRS)的评分更低,P<0.05。术后1个月,18例患儿平均的国际骨肿瘤协会(MSTS)功能评分为(26.24±1.07)分。结论:对接受可延长假体置换术后的骨肉瘤患儿进行神经减张治疗的效果显著,能缓解其术后疼痛,减少其术后的并发症,促进其患肢及患侧膝关节功能的恢复。Objective:To investigate the effect of nerve tensioning therapy on children with osteosarcoma after prolonged prosthesis replacement.Methods:Eighteen children with osteosarcoma who underwent extended prosthesis replacement in Mianyang Central Hospital in recent years were selected as the research object.After surgery,these children were treated with nerve tensioning,and then the clinical indicators were observed.Results:The length of the affected limb was 2 cm in 18 cases after operation.Among the 18 cases,5 cases had postoperative knee flexion of less than 30°,and 13 cases needed to maintain postoperative knee flexion of more than 30°(all the 13 cases could fully straighten the knee of the affected side about 2 weeks after surgery).None of these children developed serious complications after surgery,and one child developed symptoms of distal limb numbness.After 1 week of nerve tensioning treatment,18 children had lower NRS scores(P<0.05)compared with the day after surgery.One month after surgery,the mean international Society of Bone Oncology(MSTS)functional score of the 18 patients was(26.24±1.07).Conclusion:Nerve tensioning therapy has a significant effect on children with osteosarcoma after extensible prosthesis replacement,which can relieve postoperative pain,reduce postoperative complications,and promote the recovery of the affected limb and affected knee joint.

关 键 词：可延长假体置换术 骨肉瘤 神经减张治疗 并发症 

分 类 号：R726.8[医药卫生—儿科]