肿瘤型人工关节在恶性骨肿瘤保肢中的应用

摘要

Objective To evaluate the application of tumor type prosthetic replacement in limb salvage treated of malignant bone tumors. Methods Since January 2005 to December 2009,9 patients who with malignant bone tumor through biopsy confirmed were treated with tumor type prosthetic replacement were reviewed. Cancer staging according to Enneking,IB period were 3 cases, ⅡA period were 2 cases and II B period were 4 cases. Their effect, function, complications and treatment were analysed by using of tumor type prosthetic replacement. Result The results of the 9 cases had been follow-up and a total of 1 cases had been complications . One cases with cancer recurrence and one case with limb amputations caused embolization had supplemented in late days. Following up 3 ~ 59 months, an average of 28 months, Malignant tumors in patients with end-salvage rate was 94.4% and good result in functional assessment rate was 88. 9% . The artificial semi-pelvis had worst. Conclusion Tumor type prosthetic replacement can be used in malignant salvage; but it should be combined with chemo- therapy,the correct choice of indications,improving design,fixed and soft tissue reconstruction,preventing complications.%目的 探讨人工关节在四肢恶性骨肿瘤保肢术中的应用价值.方法 自2005年1月至2009年12月,分析对该院收治的经病理活检确诊的9例恶性骨肿瘤的患者,肿瘤按照Enneking分期,IB期3例,ⅡA期2例,ⅡB期4例,采用肿瘤型人工关节置换术后的效果、功能、并发症及处理.结果 9例患者皆获随访,共发生并发症1例,其中术后复发1例,栓塞致肢体截肢1例.随访3～59个月,平均28个月.恶性骨肿瘤患者最终保肢率为94.4%,功能评定优良率为88.9%,半骨盆人工关节功能最差.结论 人工关节置换术可用于恶性的保肢治疗;但应联合辅助化疗,正确选择适应证,改进假体设计、固定及软组织重建方式,预防并发症.