【作者】 黄岩；

【导师】 李宏伟；

【作者基本信息】 吉林大学 ， 外科学， 2008， 硕士

【摘要】 目的:探讨人工假体置换术在骨肿瘤治疗中的应用。方法:2000年至2008年,我科行肿瘤性假体置换术治疗长管状骨骨肿瘤25例,现将结果报下:一般数据:全组25例,平均42岁。其中骨肉瘤7例、骨巨细胞瘤12例、滑膜肉瘤3例、软骨肉瘤1例、骨软骨瘤恶变1例,骨转移癌1例。病变部位:股骨头、颈及股骨上段7例、股骨远端8例、胫骨近端6例、全股骨1例、肱骨近端3例。按照Enneking标准骨肿瘤分期,ⅠB期8例、ⅡA期13例、ⅡB期4例,分别给予肿瘤性假体置换,包括股骨近端假体7例、铰链式膝关节14例、全股骨置换1例、肱骨近端及肩关节假体置换3例。结果:本组25例病例术后给予随访2～80个月,局部复发3例,无瘤生存16例,2例患者发现远处转移, 4例患者死于原发疾病,1例患者出现感染情况经过对症治疗后好转,未发现假体松动的病例。术后依据1983年Enneking提出的保肢术术后功能评定标准来分析术后功能,本组优8例,良12例,可3例,差2例。结论:骨肿瘤患者行肿瘤性人工假体置换术后肢体功能恢复好、辅以有效的化疗可以降低复发率、延长生命并提高患者的生存质量,是恶性骨肿瘤保肢治疗的一种较为理想的方法。更多还原

【Abstract】 Objective:To evaluate application of prosthetic replacement in treatment of bone tumors.Methods: Twenty-five patients with bone tumors were treated with en bloc resection and prosthetic replacemeng in our clinical division from the year of 2000 to 2008,average age is 42,including 7 patients with osteosarcoma,12 patients with giant cell tumor of bone,3 patients with synoviosarcoma,one patient with chondrosarcoma,one patient with carcinomatous change osteochondroma,one patient with osseous metastatic carcinoma. diseased region were as follow:7 tumors were situated in proximal end of femoral bone including collum femoris and caput femoris,8 tumors were situated in distal end of femoral bone,6 tumors were situated in proximal end of tibia,1 tumors was distributed almost all over the femoral bone,3 tumors were situated in proximal end of humeral bone.According to system for the surgical staging of musculoskeletal sarcoma created by Enneking,8 paticnts belonged toⅠB stage,13 paticnts belonged toⅡA stage,4 paticnts belonged toⅡB stage. The types of the prostheses included 7 proximal femoral prostheses,14 hinged knee prostheses,1 the whole femoral bone including articulatio coxae and articular genu prosthesis,3 proximal humeral prostheses.Results :Twenty-five patients in the group were followed-up from 2 to 80 monthes. The local recurrence was seen in 3 patients, disease 16 patients survived without tumour cell, 2 patient was found tumor metastasis , 4 patients dead because of protopathy, among the total 1 patient with postoperative infection were recovered after symptomatic treatment,no prothesis looseness was found.According to the system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal created by Enneking et al in 1993, excellent case was 8 ,good case was 12, fair case was 3, poor case was 2.Conclusion:On the basis of the functional assessment after operation,we can find out that joint function of patients with bone tumor treated by prosthetic replacement recover well,moreover beside prolonging patients’life this mode of treatment can improve patients’quality of life,however there are some concurrent diseases such as postoperative infection,recurrence,prothesis looseness and so on,consequently we must grasp indication of prosthetic replacement,frame schema before operation perfectly,apply normative technique of surgical operations,take precautions against complication.Accompanying the development and innovation of medical science,Prosthetic Replacement has become a perfect limb salvage methods and the tendency in treatment of bone tumor.更多还原