40例肢体骨肿瘤及骨转移癌瘤段切除重建  

Limb salvage of bone tumor

作　　者：肖砚斌[1] 许建波[1] 李凌[1] 钱保生[1] 宣靖[1] 袁涛[1] 

机构地区：[1]昆明医学院第三附属医院骨科,昆明650018

出　　处：《中国骨肿瘤骨病》2003年第3期151-153,180,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的 探讨肢体骨肿瘤及骨转移癌行瘤段切除重建的方法和意义。方法 用5种方法30例骨肿瘤患者进行修复重建;(1)瘤段切除关节融合术;(2)瘤段切除异体半关节移植术;(3)瘤段切除人工假体置换术;(4)瘤段切除髓内针骨水泥重建术;(5)瘤灶切刮异体骨、骨水泥修复术。结果 30例骨肿瘤患者中,术后无瘤存活26例,死亡4例,其中2例局部复发而截肢。28例患者患肢功能按Enneking骨肿瘤外科治疗后功能评定标准,优良率达83.4％。10例11侧骨转移癌患者术后疼痛消失8例9侧,占81,8％,减轻2例,占19.2％;术后存活3个月以上者9例,占90％;恢复日常活动者8例,占80％。结论 综合评估肢体肿瘤患者的病情,选择合适的手术方法行瘤段切除修复重建,可为患者保留一个具有一定功能的肢体;适度的外科手术对于提高骨转移癌患者终末期的生存质量有积极的意义。Objective To investigate the clinical usage and significance to the patients with bone tumor or ma- tastasis sarcoma of extremity bone by using limb salvage. Method The following 5 methods after segmental resection of bone tumor were used to salvage limb: ① Joint fusion; ②Hemijoint Allogarfts;③Intramedullary nail with bone cement; ④Artificial endoprostheses;⑤Heterogeneous bone with bone cement. Results Among 30 cases with bone tumors, 26 cases were survival without recurrence; 2 cases died; 2 cases underwent amputation due to local recurrence. Enneking score was used to evaluate the postoperative limb function of the patient with bone tumor. The excellent and good rate was seen in 83. 4% of the cases that underwent limb salvage. Conclusion By comprehensively scoring the state of limb tu- mor and carefully selecting the suitable method of limb salvage and chemotherapy, we can salvage a limb with satisfactory function for the patients with tumor or metastasis sarcoma of bone, and thus increase the terminal quality of life of the pa- tients.

关 键 词：肢体骨肿瘤 骨转移癌 瘤段切除术 手术方法 

分 类 号：R738.1[医药卫生—肿瘤]