摘要
目的探讨骨盆恶性肿瘤手术治疗的方法.方法对16 例骨盆恶性肿瘤患者,根据术前CT或MRI表现,按Enneking分区及Enneking骨肿瘤分期分类.对Enneking骨肿瘤分期Ⅱ期及转移瘤病人,术前化疗3个疗程.先行双侧髂内动脉结扎,对能保留骨盆承重环的Ⅰ区、Ⅲ区、Ⅳ区肿瘤,直接手术扩大切除,不能保留骨盆承重环的Ⅰ区、Ⅲ区、Ⅳ区肿瘤,手术扩大切除肿瘤,自体或异体骨移植+重建钢板固定.Ⅱ区肿瘤,手术扩大切除肿瘤,可调式人工半骨盆置换或瘤块切除,克式针固定骨水泥填塞.结果术后随访1～3.5 a,平均2.8 a.所有病人均能下地行走,无肢体短缩.结论根据骨盆肿瘤的部位选择相应的术式,可以最大限度地保留肢体功能.术前化疗和双侧髂内动脉结扎可提高骨盆肿瘤的切除率.
Objective To explore the surgical treatment of pelvic malignant tumor. Methods According CT or MRI, 16 cases of pelvic malignant tumor were classified by Enneking stage and Enneking partition. Patients with stage Ⅰ or metastases were treated by chemotherapy for 3 courses. The hypogastric artery were ligated at first. Tumor can be resected directly in region Ⅰ,Ⅱ,Ⅳ whose weight bearing ring can be reserved. If not, bone graft and plate were used. In region Ⅱ , hemipelvic megaprosthesis were implanted or implanted with bone cement. Results Patients were followed up from 1 to 3.5 years （average 2.8 years）. All patients can walk without lower limbs discrepancy. Conclusion The classification system depending on the lesions location in pelvic tumor is useful to select operative procedure to retain limb function to great extent. Preoperative chemotherapy and hypogastric artery ligation are helpful to resect tumor wholely.
出处
《实用骨科杂志》
2005年第5期395-397,共3页
Journal of Practical Orthopaedics
关键词
骨盆肿瘤
手术
髂内动脉结扎
pelvic tumor
operation
hypogastric artery ligation
