摘要
目的探讨不同的治疗方法在肘关节周围骨肿瘤保肢中的应用价值。方法分析比较16例肘关节周围骨肿瘤患者分别进行各种保肢手术后的效果、生存质量、并发症及处理。本组骨肉瘤患者均采用新辅助化疗即:术前化疗+手术+术后化疗。在肿瘤切除后,采用人工关节置换6例,大段异体骨移植3例,骨水泥填充3例,单纯切除无重建者3例,短缩融合1例。结果16例骨肿瘤患者术后出现远处转移的共3例,为肺转移,2例骨巨细胞瘤行刮除骨水泥填塞局部复发而行瘤段切除假体置换术,1例复发恶变行瘤段切除短缩融合术。2例骨肉瘤软组织复发而截肢。3例行瘤段切除无重建者均为尺骨近端恶性骨肿瘤,术后肘关节功能恢复较好。结论在肘关节周围骨肿瘤保肢手术中,肿瘤广泛切除后、骨重建技术的进步是增加保肢手术范围、改善功能效果、降低手术并发症的关键。尺骨近端的恶性骨肿瘤采用瘤段切除局部旷置不失为一种较好的保肢治疗方法。
Objective To investigate clinical value of limb salvage for malignant bone tumor around the elbow with different kinds of operative methods. Methods The postoperative effects, survival quality, complications and disposal were analysed and compared in 16 patients after limb salvage for malignant bone tumor around the elbow with different kinds of operative methods. All patients underwent new adjuvant chemotherapy, i.e. ＂preoperative chemotherapy plus operation plus postoperative chemotherapy＂. Operated method was to resect tumor,6 cases had been performed prosthetic replacement, 3 cases performed large segment allografts, 3 cases performed packing with osseous cement, 3 cases performed only resection with no reconstruction and 1 case performed bone fusion after tumor resection. Results 3 of all cases had lung metastasis. 2 cases malignant giant tumor packing with osseous cement had been performed prosthetic replacement after tumor resection because of local recurrence. 2 cases had been amputated because of bone sarcoma parenchyma recurrence. The paper emphasized that 3 cases in ulna close extremity with no reconstruction had no recurrence and good elbow function. Conclusions After wide bone resection for limb salvage of bone sarcoma around the elbow, technic advancement for bone reconstruction is the key to add operative ranges for limb salvage, enhance functional effect and decrease operative complications. But no reconstruction is also an ideal method for limb salvage for the poor and malignant tumor in ulna close extremity.
出处
《中国骨肿瘤骨病》
2006年第1期35-38,共4页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
肘关节
骨肿瘤
化疗
保肢手术
Elbow
Bone tumor
Chemotherapy
Limb salvage
