骶骨原发肿瘤患者中高位切除术后功能恢复情况评估  

Evaluation of functional recovery after mid-to-high resection of primary tumors of the sacrum

作　　者：姜勇[1] 丁永利[1] JIANG Yong;DING Yongli(Department of Orthopedics,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099,China)

机构地区：[1]河南中医药大学第一附属医院骨伤科,河南郑州450099

出　　处：《肿瘤基础与临床》2022年第2期131-135,共5页journal of basic and clinical oncology

摘　　要：目的探讨骶骨原发肿瘤患者中高位切除术后功能与影像学表现恢复情况。方法入组中高位骶骨肿瘤单纯切除术后患者15例,术后通过门诊及电话随访,记录患者术后的运动功能、大小便功能与影像学表现情况,对比不同层面骶骨切除术后患者的运动功能、大小便功能及影像学表现,探讨保留不同节段骶神经根对患者日常生活的影响。结果15例患者术后肌肉骨骼肿瘤学会功能评分为(27.53±2.68)分,所有患者均可行走,13例患者不需要借助支持物可行走,余2例患者行走时需要借助助行器。3例保留单侧S_(3)的患者1例无排尿费力及尿失禁,1例无排便费力,2例无大便失禁;6例保留双侧S_(3)的患者4例无排尿费力及尿失禁,4例无排便费力,5例无大便失禁。影像学未见残余骶骨下沉,未发生残余骶骨骨折。结论骶骨原发肿瘤经S_(2~3)平面及以下切除术后患者的运动功能及局部稳定性尚可,保留单侧S_(3)神经根对于患者术后二便功能尤为重要,保留双侧S_(3)神经根的患者术后二便功能明显优于保留单侧S_(3)者。Objective To investigate the function and imaging status of patients with primary tumors of the sacrum after mid-to-high resection.Methods A total of 15 patients with primary tumors of the sacrum after mid-to-high resection were followed up through outpatient clinics and telephones.The postoperative motor function,bowel and bladder function and imaging status of the patients were recorded,and those of patients after sacrotomy at different levels were compared.The influence of preservation of different segments of sacral nerve roots on daily life of patients were explored.Results The postoperative musculoskeletal tumor society score of the patients was(27.53±2.68)points.All the patients could walk,13 patients could walk without support,and 2 patients needed walking aids when walking;of 3 patients who retain unilateral S_(3),1 patient had no urination effort and incontinence,1 patient had no defecation effort,and 2 patients had no fecal incontinence;6 patients who retain bilateral S_(3),4 patients had no urination effort and incontinence,4 patients had no defecation effort,and 5 patients had no fecal incontinence.No subsidence of the residual sacrum was found on imaging,and no fracture of the residual sacrum occurred.Conclusion The motor function and local stability of patients with primary tumors of the sacrum after resection of S_(2-3) level and below are acceptable.Preservation of unilateral S_(3) nerve root is particularly important for postoperative defecation function of patients.The postoperative defecation function of patients with preservation of bilateral S_(3) nerve roots is significantly better than that of patients with preservation of unilateral S_(3).

关 键 词：骶骨肿瘤切除术 运动功能 二便功能 影像学评价 

分 类 号：R738.1[医药卫生—肿瘤]