微波消融联合骨水泥、锁定钢板内固定治疗长骨干转移癌

目的探讨原位微波消融联合骨水泥、锁定钢板内固定治疗四肢长骨干转移癌的疗效。方法回顾性分析2010年3月~2018年6月我科收治的17例四肢长骨干转移癌患者的临床资料,其中病理性骨折3例,均采用原位微波消融、病灶刮除后联合骨水泥填充、锁定钢板内固定治疗,手术部位:股骨7例,肱骨6例,胫骨4例。结果所有患者均顺利完成手术,无术中并发症。所有患者术后均获得随访,随访时间5~27个月。术后3月VAS评分、MSTS评分、KPS评分较术前明显改善,差异均有统计学意义(P<0.05)。术后14个月出现右股骨钢板断裂并骨折1例,术后20个月出现左肱骨转移灶复发1例。随访期间死亡12例,存活5例。术后半年、1年及2年生存率分别为94.1%,60.8%及8.9%。结论采用原位微波消融联合骨水泥填充、锁定钢板内固定治疗四肢长骨干转移癌,可以降低肿瘤局部复发率,缓解疼痛,恢复患肢功能,改善患者生活质量。

Microwave Ablation Combined with Bone Cement Filling and Locking Plate Fixation for Long Bone Metastases

Objective To investigate the effect of microwave ablation combined with bone cement filling and internal fixation of locking plate for long bone metastases.Methods The clinical data of 17 patients with long-backbone metastases of the limbs treated by in-situ microwave ablation,curettage combined with bone cement filling and internal fixation of locking plate from March 2010 to June 2018 were analyzed retrospectively,including 3 cases of pathologic fractures.The lesion located in femur in 7 cases,humerus in 6 cases and tibia in 4 cases.Results All patients complete the surgery successfully without complication during the surgery.All cases were followed for 5 to 27 months.The VAS score,MSTS score and KPS score were significantly improved 3 months after the surgery than those before the surgery,and all the differences were statistically(P<0.05).One case was found plate broken and fracture of right femur 14 months after the surgery,and one case relapsed of left humerus metastasis 20 months after the surgery.There were 12 of death and 5 of survival during the follow-up period.The survival rate of 0.5-,1-and 2 year was 94.1%,60.8%and 8.9%respectively.Conclusion The surgery of microwave ablation combined with bone cement filling and internal fixation of locking plate can reduce the local recurrence rate of the tumor,relieve the pain,restore the function of the involved limb and improve the quality of life of the patients with long bone metastasis of extremities.