射频消融在骨肿瘤切开手术中的应用

目的探讨骨肿瘤切开手术中使用射频消融的安全性和有效性。方法应用射频消融治疗、有完整随访的骨肿瘤患者15例。姑息组为转移癌10例和骨髓瘤1例，共消融13处病灶，切开后先消融，再去除肿瘤；肿瘤全切组为累及髋臼的原发恶性或侵袭性肿瘤4例，先切除大部分肿瘤，只对髋臼区行射频消融，刮除髋臼肿瘤，保留髋臼骨质，以利重建。从手术技术、肿瘤学、并发症、肢体功能等方面综合评价此方法的临床应用效果。结果随访1—29个月、平均17个月。姑息组死亡9例，平均存活10个月（1～24个月），消融处均无肿瘤复发；肿瘤全切组有1例软骨肉瘤术后13个月复发，复发率25％。1例术中在止血带处发生热损伤，1例术后皮缘坏死。以MSTS评分标准对术后存活超过6个月的11例患者进行功能评定，优良率为81．8％。结论切开后行射频消融术对于骨转移癌和侵及髋臼的侵袭性肿瘤是一种安全有效的方法。

Application of open radiofrequency ablation in therapy of bone tumors

Objective To evaluate the safety and clinical effect of the treatment for bone tumors by open radiofrequency ablation.Methods Fifteen patients who were treated with radiofrequency ablation and had complete follow-up were divided into 2 groups.In the palliative group,ablation was performed before resection of the tumor.There were totally 13 lesions treated in this group which included 11 patients(10 with bone metastasis and 1 with myeloma).In the curative group,ablation was performed after resection of the t...