肿瘤型人工关节置换治疗股骨上段转移癌并病理性骨折的临床研究  

Clinical study of endoprosthetic replacement in the treatment of proximal femoral metastatic cancers with pathological fracture

作　　者：王体颖 杨祚璋[1] 柳艳 朱亚南 杨义豪[1] 王操 陈秋云 张娅[1] 陈先维 袁涛[1] 张晶[1] 李东奇[1] Wang Tiying;Yang Zuozhang;Liu Yan;Zhu Yanan;Yang Yihao;Wang Cao;Chen Qiuyun;Zhang Ya;Chen Xianwei;Yuan Tao;Zhang Jing;Li Dongqi(Department of Orthopaedics,Third Affiliated Hospital of Kunming Medical University(Cancer Hospital of Yunnan Province),Kunming Yunnan,650118,China)

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院)骨外一科,昆明650118

出　　处：《中华转移性肿瘤杂志》2023年第1期35-40,共6页Chinese Journal of Metastatic Cancer

基　　金：国家自然科学基金(U1702283,81372322)。

摘　　要：目的探讨肿瘤型人工关节置换术治疗股骨上段转移癌并病理性骨折患者的临床疗效及并发症。方法回顾性分析2016—2018年间在昆明医科大学第三附属医院(云南省肿瘤医院)行肿瘤型人工关节置换术的42例股骨上段转移癌并病理性骨折患者的临床资料,其中男22例、女20例,年龄34~86岁,原发肿瘤类型包括肺癌24例、乳腺癌10例、前列腺癌3例、肾癌2例、甲状腺癌1例、结肠癌1例、食管癌1例。采用VAS评分及KPS评分对患者术前以及术后1、3、6个月的疼痛情况和生活状况进行评估,采用MSTS 93评分评价髋关节功能,Kaplan-Meier法分析总生存期。结果42例患者术前VAS评分为7.93±0.80,KPS评分为34.29±5.01,MSTS 93评分为7.67±1.43。术后1、3、6个月的VAS、KPS评分和MSTS 93评分较术前均有所改善(P均<0.001)。随访时间为5~32个月,中位生存期10个月。术后5例患者出现并发症。结论对股骨上段转移癌并病理性骨折的患者采用肿瘤型人工关节置换可早期恢复髋关节功能,缓解疼痛,提高生活质量且术后并发症少。Objective To investigate the clinical efficacy and complications of endoprosthetic replacement in the treatment of proximal femoral metastatic patients with pathological fracture.Methods A retrospective analysis of the clinical data was performed in 42 cases of proximal femoral metastatic cancers with pathological fracture who underwent endoprosthetic replacement in the Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital)from June 2016 to December 2018,including 22 males and 20 females,aged 34 to 86 years old,their primary tumor types included 24 lung cancer,10 breast cancer,3 prostate cancer,2 kidney cancer,1 thyroid cancer,1 colon cancer,and 1 esophageal cancer.The VAS and KPS scores were used to evaluate the pain and living conditions of patients in pre-operation and 1,3,and 6 months after operation,The MSTS 93 score was used to evaluate hip joint function,and the overall survival time was analyzed by Kaplan-Meier method.Results The VAS score of 42 patients was 7.93±0.80,the KPS score was 34.29±5.01,and the MSTS 93 score was 7.67±1.43 before operation.The VAS scores,KPS scores and MSTS 93 scores at 1,3,and 6 months after operation were improved differently compared with those before operation(all P<0.001).The patients were followed up for 5 to 32 months,with the median survival time of 10 months.Five patients had surgery-related complications after operation.Conclusions Endoprosthetic replacement for patients with metastatic cancer of the proximal femur with pathological fracture can restore hip joint function early,effectively relieve pain,improve quality of life,and have fewer postoperative complications,so that good clinical results can be obtained.

关 键 词：股骨上段 转移癌 肿瘤型人工关节置换 外科治疗 

分 类 号：R738.1[医药卫生—肿瘤] R687.4[医药卫生—临床医学]