儿童膝关节周围骨肉瘤治疗中肢体生长潜能保留的研究进展与展望  

Preservation of Limb Growth Potential in Treatment of Pediatric Osteosarcoma Around the Knee:Research Progress and Future Prospect

作　　者：赵志庆 郭卫[2] 燕太强 ZHAO Zhiqing;GUO Wei;YAN Taiqiang(Department of Orthopedics,Peking University First Hospital,Beijing 100034,China;Musculoskeletal Tumor Center,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学第一医院骨科(骨肿瘤),北京100034 [2]北京大学人民医院骨肿瘤科,北京100034

出　　处：《肿瘤防治研究》2024年第11期898-907,共10页Cancer Research on Prevention and Treatment

基　　金：北京大学第一医院国自然培养基金(2024PY12)。

摘　　要：影像学的发展、外科技术的进步、多药物联合化疗以及术后肢体功能康复的密切配合,使保肢后肿瘤局部复发率和患者的生存率达到了与截肢相同的临床结果,保肢已成为现代肢体恶性骨肿瘤治疗的流行趋势。膝关节周围,包括股骨远端和胫骨近端,是骨肉瘤最好发的部位。瘤段截除后使用金属假体置换替代骨缺损是保肢最常用的方法,也是患者术后迅速恢复肢体功能最可靠的保肢手段。本篇讨论的主要是临床上面临的儿童骨肉瘤保肢技术的一个挑战,如何最大限度地保留儿童患肢肢体生长潜能,从而减少日后双下肢肢体不等长问题,是保肢技术发展几十年来最前沿的精准医疗技术跨越之一。根据股骨远端肿瘤与骨骺生长板之间的距离牺牲或保留膝关节,保留肢体生长潜能,3D打印重建假体越来越受到青睐。本文对儿童膝关节骨肉瘤的外科治疗进展及未来发展方向进行总结,以期对骨肿瘤医生治疗该部位疾病提供一定帮助。With the development of imaging technology,advancements in surgical techniques,application of multidrug chemotherapy,and collaboration in postoperative rehabilitation,the local recurrence rate and survival of patients with osteosarcoma after limb-sparing surgery are comparable to those of patients after amputation.The area around the knee joint,including the distal portion of the femur and the proximal portion of the tibia,is a typical site of involvement for osteosarcoma.Metal prosthetic replacement is the most common method to reconstruct bone defect after tumor resection,which provides rapid recovery of limb function after surgery.This article mainly discusses the clinical challenge of limb-saving technology for pediatric osteosarcoma.It also describes how to optimally preserve the growth potential of children’s affected limbs to reduce the future limb length discrepancy.Limb-sparing technology is one of the most cutting-edge precision medical technologies in the industry.Sacrificing or preserving the knee joint according to the distance between the tumor of distal femur and the epiphyseal growth plate,retaining the potential for limb growth,3D-printed reconstructed prostheses are becoming increasingly popular.This article summarizes the progress and future development in the surgical treatment of pediatric osteosarcoma around the knee to offer insights for orthopedic treatment of this disease.

关 键 词：儿童骨肉瘤 保肢 生长潜能 外科治疗 未来发展 

分 类 号：R738.1[医药卫生—肿瘤]