摘要
目的 探讨肩部恶性骨肿瘤保肢治疗的方法选择。方法 自 1 992年 ,我们对 1 9例肩部恶性骨肿瘤实施了保肢术。男 1 2例 ,女 7例 ;年龄 1 4～ 60岁 ,平均 2 9 8岁。肱骨上端 1 3例 ,肩胛骨 6例。软骨肉瘤 7例 ,骨肉瘤 4例 ,转移癌 3例 ,骨巨细胞瘤 3例 ,尤文肉瘤 2例。瘤段切除灭活再植术 5例 ,全肩胛骨切除、肱骨头吊悬术 4例 ,瘤段切除同侧锁骨移植术 4例 ,瘤段切除人工关节置换术 2例 ,肩胛骨部分切除术 2例 ,瘤段切除自体腓骨移植术和瘤段切除骨水泥充填术各 1例。术后应用化疗骨肉 4例瘤、软骨肉瘤 3例和尤文肉瘤 2例。结果 1 9例患者中 3例失访 ,1 6例随访平均 2年 2个月 ( 3个月～ 7年 )。 1例复发 ;4例发生肺转移 ;6例死亡。根据Enneking肢体功能评价标准 :优 4例 ,良 5例 ,可 5例 ,差 2例。结论 对于肩部恶性骨肿瘤应根据肿瘤的不同部位选择不同的手术方法 ,不仅可以达到彻底切除肿瘤的目的 ,而且还可以保存一定的肩部功能。
Objective To investigate the limb salvage strategy in malignant tumor resection around the shoulder.Methods 19 patients underwent limb salvage procedures for treatment of malignant tumors around the shoulders since 1992.There were 12 in males and 7 in females and with the mean age of 29.8 years old.There were 7 osteochondrosarcomas,4 osteosarcomas,3 metastatic carcinomas of bone,3 giant-cell tumors of bone,2 Ewing sarcomas.5 lesions were treated with reimplantation of tumor-bearing bone after alcohol devitalization,4 with the total scapula resection and the head of humerus slinging,4 with the tumor-bearing bone resection and construction with free periosteum vascularized clavicle,2 with tumor resection and replacement of prosthesis,2 with the part scapula resection,1 with fibula grafting and 1 with bone cement.Results 16 cases were followed-up with the mean time of 2.2 years(3 months～7 years).1 case recurred,4 cases had lung metastasis and 6 died.The limb functional results were excellent in 4 cases,good in 5,fair in 5 and poor in 2.Conclusions According to the different location of the malignant bone tumors around shoulders to perform different limb-salvage could resect the tumor and reserve the function of the joint.
出处
《中国骨肿瘤骨病》
2004年第3期144-146,共3页
Chinse Journal Of Bone Tumor And Bone Disease
