摘要
目的：探讨四肢转移性瘤手术治疗的方法与疗效。方法：2000年2月至2005年2月明确诊断的102例四肢骨转移性瘤患者中，64例接受外科手术治疗，其中异体骨复合人工关节置换10例，单纯肿瘤人工关节置换10例，异体骨加带锁髓钉内固定14例，骨水泥加带锁髓钉内固定7例，异体骨加钢板内固定12例，骨水泥加钢板内固定11例。结果：无术中死亡，术后无感染。64例患者随访6-60个月，平均29个月。1例股骨近端肿瘤人工关节置换和1例股骨中段异体骨植骨加髓钉固定于术后3月出现假体及内固定松动，2例股骨骨水泥加髓钉内固定分别于术后4、5个月出现松动。36例异体骨移植患者中，3例在随访结束时移植骨与宿主骨未达到骨性愈合，但不影响功能。所有患者术后疼痛得到明显缓解，Enneldng评分：功能为优75．2％，中18．3％，差6．5％。患者2年生存率为36．2％，5年生存率为18．75％。结沧：手术治疗四肢转移性瘤可以有效缓解疼痛、预防病理性骨折的发生、改善肢体功能及提高患者的生存质量。
Objective： To study the methods and therapeutic effects about surgical treatments of metastasis in limbs, Methods： 41 male and 23 female with an average age of 56.2 have been studied retrospectively among 102 patients who diagnosed as metastasis between February of 2000 and February of 2005. 64 patients received operations including allograft - prosthetic composite, allograft and intramedullary nailing or plate fixation, cemement and intramedullary nailing or plate fixation. Results： All the patients were followed up after postoperative intervals ranging from 6 ~ 60 months with an average period of 29 months. One case with total hip replacement and one case with allagraft and intramedullary nailing were found loosening in 3 months postoperatively. 2 cases had loosening of intramedullary nailing in 4 and 5 months after operation respectively. 3 cases with allograft had no bone heeling at the end of follow- up. According to Enneking Score System, 75.2% of the case was excellent, 18.3% was good and 6.5 % was poor. Conclusion： For the patients with metastasis in limbs who were suffering from the pathological fracture and impending pathological fracture, the surgical treatments could result in the pain - relieving and life - improving.
出处
《华西医学》
CAS
2007年第1期80-82,共3页
West China Medical Journal
