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插入式微波天线阵列诱导高温治疗长骨骨巨细胞瘤 总被引:1,自引:0,他引:1
AIM: To evaluate the surgical treatment methods of giant cell tumors (GCT) of long bone in conjunction with inserted microwave antennas induced hy-perthermia, METHODS: 46 patients, included the surgical procedures, the oncology results, the functions of the limbs and the complications were analyzed. RESULTS: Follow-up 3. 5 to 9 yean (mean 5. 5 yean). All patients were evaluated according to oncological and orthopaedic criteria. Two tumors were recurred. Orthopaedic function were perfect in 44 patients and were fair in 2. Infection was found in 2 patients. CONCLUSION: The surgical procedure to treat the giant cell tumors of long bone by inserted microwave antennas induced hyperthermia is a definitive surgical method which is safe and confident. 相似文献
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长骨骨巨细胞瘤微波高温治疗肢体关节功能观察评定 总被引:2,自引:2,他引:2
目的评价长骨骨巨细胞瘤原位分离插入式微波天线阵列诱导高温原位灭活治疗后肢体关节功能。方法应用原位分离插入式微波天线阵列诱导高温灭活技术治疗46例长骨骨巨细胞瘤,从手术技术、肢体关节功能等方面全面综合评价此方法临床应用后肢体关节功能学结果。结果应用该方法治疗46例长骨骨巨细胞瘤,平均随访7.6年。肢体关节功能评定:好者44例,可者2例,差者0例。结论应用原位分离插入式微波天线阵列诱导高温治疗长骨骨巨细胞瘤能获得优良的肢体关节功能。 相似文献
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目的探讨持续被动活动(CPM)在微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤术后关节功能康复中的意义。方法微波诱导高温原位灭活保肢手术治疗膝关节周围恶性或侵袭性骨肿瘤,灭活处骨缺损应用脱钙骨基质颗粒加骨水泥修复,局部用钢板或异体皮质骨板内固定,不用外固定。将75例患者随机分为A、B两组。A组40例,术后24h开始使用CP对患肢进行持续被动功能锻炼,连续3周。B组35例术后进行常规功能锻炼。结果75例均获随访,平均随访时间13个月,骨缺损处无骨折和骨不连,内固定良好。至3个月时,A组膝关节活动度110°~160°,平均141°,B组膝关节活动度90°~140°,平均126°,统计学差异有显著性意义,P<0.01。结论微波诱导高温原位灭活治疗膝关节周围骨肿瘤保肢手术,能最大程度地保留膝关节功能术后CPM能进一步改善膝关节的活动度。 相似文献
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《中国临床康复》2002,6(20):3144-3145
Objective To evaluate the limb and joint function after treatment the pelvic bone tumors by the microwave hyperthermia inserted antenna arrays .Methods 51 patients were treated by inserted microwave antenna arrays induced hyperthermia. All patient limb and joint functions were observed and analyzed from oncology,function and complications. Results There were 9 recurred cases and 7 of them died. Among the remaining 42 patients, 26 patients had excellent and good limb and joint function, 6 patients had fair function. Conclusions By the method of inserted microwave antenna arrays induced hyperthermia to treat the pelvic tumors the limb and joint function was excellent. 相似文献
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周勇 范清宇 马保安 张明华 沈万安 ZHOU Yong FAN Qing-yu MA Bao-an ZHANG Ming-hua SHENG Wan-an 《中国组织工程研究与临床康复》2002,6(20):3144-3145
Therearemanyofimportantorgans,forinstance,thebloodvessels,nerves,rectum,bladder,ureter,inthepelvicarea.Itisverydifficultforthepelvicbonetumorstodiagnoseearly.Whilethedi-agnoseswerefinishedthetumorencroachedscopeswouldbewidespread.Nowthesurgicaltreatmentmethodsofthepelvicbonetumors,includingofamputation,reconstructionofthebonedefect,mightresultedinthefunctionalincapacitationofthelimbandjoint犤1-4犦.Since1994wehaveusedanalternativesurgicaltreatmentproceduresofinsertedmicrow… 相似文献
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原位分离插入式微波天线阵列诱导高温治疗四肢成骨肉瘤肢体关节功能学结果评价 总被引:3,自引:3,他引:3
目的评价原位分离插入式微波天线阵列诱导高温治疗四肢成骨肉瘤功能学结果。方法从手术技术、肢体关节功能等方面全面综合评价此方法临床应用后肢体关节功能学结果。结果平均随访4.9年。16例术后8个月~2年内因肿瘤转移死亡。72例存活,生存率为74%。72例肢体成骨肉瘤存活者中,5例因局部复发截肢,3例局部复发行瘤段切除大段异体骨融合术治愈。72例肢体关节功能,优良50例,可7例(包括3例大段异体骨融合术患者),5例佩戴义肢患者功能为差。优良率为70%。结论该法治疗后肢体关节功能优良,优良率70%,方法创新、安全有效、临床效果显著。 相似文献
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目的 探讨上肢康复训练联合微波热疗对乳腺癌患者经外周静脉穿刺中心静脉置管术(PICC)后静脉血流及血栓的影响.方法 选取行PICC置管的乳腺癌患者80例为研究对象,采用随机数字表法分为对照组和观察组,每组40例.对照组接受常规护理干预,研究组接受上肢康复训练联合微波热疗干预.比较2组置管前后腋静脉血流速(Vmax)、单... 相似文献
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目的比较X线、CT、MRI对骨巨细胞瘤的诊断特点及其鉴别诊断,以提高对骨巨细胞瘤的影像诊断能力。方法对23例经手术和病理证实的长骨骨巨细胞瘤的X线、CT、MRI表现进行影像对照、对比分析。结果长骨骨巨细胞瘤多发生在股骨下端和胫骨上端,X线表现为长管状骨骨端偏心性、膨胀性骨质破坏,骨壳多薄而完整,其间可见骨间隔,典型者构成皂泡样改变。CT扫描显示大多数骨壳并不完整,肿瘤内看不到真正的骨间隔。溶骨性巨细胞瘤呈溶骨性改变,多无完整的骨壳和骨间隔,肿瘤的边缘残留的骨壳仍保留膨胀的特征,并可看到和骨壳缺损区相一致的软组织肿块。CT还能清楚地显示肿瘤内有无出血、破坏、钙化等内部结构。肿瘤呈膨胀性破坏,T1WI呈均匀中等或低信号强度,T2WI呈混杂信号,有些区域呈高信号,为液化、坏死或出血。结论大多数骨巨细胞瘤有典型的X线表现,不难作出正确的诊断,结合CT、MRI可提高骨巨细胞瘤的诊断和鉴别诊断能力。 相似文献
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肿瘤型假体置换治疗近关节部位骨巨细胞瘤37例临床分析 总被引:1,自引:0,他引:1
目的 评价肿瘤型假体置换治疗近关节部位骨巨细胞瘤(GCT)的疗效.方法 1998年1月至2008年1月收治近关节部位GCT 37例.股骨远端23例,胫骨近端10例,肱骨近端3例,股骨近端1例.Companacci分级,Ⅱ级9例,Ⅲ级28例.所有患者行瘤段切除、肿瘤型假体置换治疗.术后采用MsTS 93评分系统进行功能评价.结果 随访2~9年,1例术后2年3个月肿瘤局部复发,1例接受截肢手术.1例假体感染,2例假体松动.术后3年MSTS 93评分系统评分平均为(22.49±5.16)分.肢体功能评估优良率为89.2%(33/37).结论 肿瘤型假体置换是近关节部位GCT减少复发、重建功能的一种有效方法. 相似文献
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背景:同种异体骨是临床常用的骨移植材料,但缺乏诱导成骨能力是最大的问题。目的:评价良性骨肿瘤及瘤样病变刮除或切除后应用同种异体骨复合自体骨髓干细胞修复骨缺损的效果。方法:65例良性骨肿瘤(包括瘤样病变)患者,根据植骨情况分为2组。复合骨髓干细胞植骨组35例患者根据预计植骨量从每位患者两侧的髂前上棘或髂后上棘抽取红骨髓20-40 mL,经体外分离、纯化、培养扩增骨髓基质干细胞备用,在植骨前将同种异体骨颗粒与骨髓基质干细胞充分混匀。肿瘤刮除或切除后,将混匀的骨髓基质干细胞与同种异体骨颗粒,植入骨缺损区内。单纯植骨组将用生理盐水浸泡半小时的同种异体骨植入骨缺损区内。分别于治疗后1,3,6,12个月进行植骨区X射线检查,比较两组病例同种异体骨颗粒界限模糊、消失的时间,同时观察术后并发症发生情况。结果与结论:62例患者均获得12个月以上随访。复合骨髓干细胞植骨组移植骨界限模糊时间和消失时间均短于单纯植骨组(P <0.05)。复合骨髓干细胞植骨组1例出现排异反应,使用免疫抑制剂治疗2周后痊愈,两组病例均未出现感染。结果表明同种异体骨复合自体骨髓干细胞植骨能明显促进骨融合和骨缺损的愈合。 相似文献
11.
Human giant cell tumors of bone identification and characterization of cell types. 总被引:9,自引:4,他引:5
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S R Goldring M S Roelke K K Petrison A K Bhan 《The Journal of clinical investigation》1987,79(2):483-491
Cells cultured from human giant cell tumors of bone were characterized on the basis of morphological features, proliferative capacity, presence of granulocyte-monocyte antigens, receptors for skeletal hormones, and soluble cell products. Three major cell types were identified. One population consisted of mononuclear cells with fibroblastic morphology, which proliferated in culture and most likely represent the neoplastic element of the tumor. Phenotypically they resembled a connective tissue stromal cell. A second population of mononuclear cells lacked receptors for skeletal hormones and did not persist in culture. These cells were likely of monocyte-macrophage lineage. A third population of cells consisted of large multinucleated giant cells. These cells possessed phenotypic features of osteoclasts including receptors for calcitonin. Human giant cell tumors of bone are most likely a neoplasm of connective tissue stromal cells, which have the capacity to recruit and interact with multinucleated giant cells that exhibit phenotypic features of osteoclasts. 相似文献
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热化疗诱导胶质瘤细胞凋亡的实验研究 总被引:5,自引:3,他引:5
目的 研究热化疗对C6细胞凋亡的影响,评价热化疗抑制细胞增殖的价值。方法 将不同浓度的丝裂霉素直接作用于体外培养的C6胶质瘤细胞,接种后20h,48h接种后42.7℃恒温箱中加温2次,每次30min。观察丝裂霉素对C6细胞的抑制率,生长曲线的影响及热疗,化疗,热化疗对C6细胞凋亡的诱导作用。结果 丝裂霉素在1.5μg/ml浓度时杀伤作用达高峰(P<0.001),再加大浓度并不增加杀伤作用(P>0.05);透射电镜,FCM,TUNEL均观察到热疗,化疗,热化疗诱导细胞凋亡的作用(P<0.001),热化疗有协同作用(P<0.001)。结论 (1)热疗,化疗,热化疗均抑制C6细胞增殖。(2)热疗,化疗,热化疗诱导细胞凋亡为其抗癌机制之一。(3)热疗能提高化疗药物的细胞毒性作用。 相似文献
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目的探讨骨巨细胞瘤手术治疗的临床效果。方法 2000年8月至2010年9月手术治疗33例骨巨细胞瘤患者,其中肿瘤切除﹢石炭酸烧灼、酒精局部灭活﹢骨水泥填塞术10例;病灶刮除﹢植骨6例;单纯瘤段切除5例;瘤段切除人工假体置换5例;瘤段切除关节融合4例;病灶刮除术治疗Ⅲ期患者3例。结果全部患者均获得随访,随访时间6个月~4.5年,平均2.6年。病灶刮除骨水泥填充10例,肿瘤复发2例;病灶刮除植骨6例,肿瘤复发1例;单纯瘤段切除5例,肿瘤复发1例;瘤段切除人工假体置换5例,肿瘤复发0例。瘤段切除关节融合4例,肿瘤复发0例;病灶刮除术治疗Ⅲ期患者3例,肿瘤复发1例。结论手术治疗骨巨细胞瘤的临床效果是令人满意的,但其复发是一个值得注意的问题。 相似文献
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吴辰 《临床和实验医学杂志》2012,(24):1940-1941
目的观察局部微波热疗与化疗联合应用于胸壁复发乳腺癌的近期疗效。方法采用局部微波热疗联合化疗治疗乳腺癌胸壁复发患者,并与单用化疗患者进行对比,比较其治疗有效率与不良反应。结果与单用化疗相比,局部微波热疗联合化疗能够显著提高患者治疗有效率,不良反应则无显著差异。结论局部微波热疗联合化疗是治疗乳腺癌胸壁复发的良好方法。 相似文献
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目的研究探针式热疗探头在骨肿瘤微波热疗中产生电磁场分布的模拟数值结果。方法取分层柱状结构骨肿瘤模型,将同轴电缆剥掉外导体后构成探针式探头。采用有限元数值分析方法,对不同插入深度及不同尺寸的同轴探头在组织中产生的电磁场进行数值模拟计算。结果当探头外导体的截断面处于组织内部时,辐射能量能较好地集中于被辐射组织中;当探头接近被辐射组织顶端但又不穿透时,可使顶端辐射增强。结论热疗时探头不同的插入深度及规格,可使被辐射组织的电磁场发生相应变化,故在临床微波热疗操作中,应根据肿瘤大小、部位等特性合理选择探头尺寸进行治疗。 相似文献
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Background. Neoplasms of limbs are appear as primary of changes or as bone metastases.
Material and methods. In 1989-2002 due to neoplasms limbs 795 patients were hospitalised, of which 278 suffered from malignant metastases to bones. In this group, 242 patients with lesions localised within the femoral (169), humeral (55) and tibial (18) bones were identified. In 75% of patients pathological fractures were diagnosed, in the remaining ones the metastasis was manifested in the form of osteolytic lesion. In most cases early surgical treatment was performed to eliminate pain complaints, improve patient's physical mobility through restoration of limb functions and also to enable nursing care to be performed in palliative management. The choice of treatment method depended on: location of metastasis, degree of bone tissue destruction, type of primary tumour, progression of malignant process and technical resources. Within the long bones intramedullary nails (189) of different generations were implanted. In the proximal part of femoral bone various types of endoprostheses (65) were used, enabling oncological radicalism and early rehabilitation of the patients.
Results. Resection of bones with neoplasm-induced lesions, filling the lesion with bony cement and stabilisation with blocking nails permitted early rehabilitation of patients. In our material the most common malignancies inducing metastases were: breast, kidney, lung cancers and myeloma. Patients with these neoplasms constituted nearly 74% of all hospitalised subjects.
Conclusions. Necessity of systemic management and importance of early surgical treatment of metastases in specialized centres were underlined. 相似文献
Material and methods. In 1989-2002 due to neoplasms limbs 795 patients were hospitalised, of which 278 suffered from malignant metastases to bones. In this group, 242 patients with lesions localised within the femoral (169), humeral (55) and tibial (18) bones were identified. In 75% of patients pathological fractures were diagnosed, in the remaining ones the metastasis was manifested in the form of osteolytic lesion. In most cases early surgical treatment was performed to eliminate pain complaints, improve patient's physical mobility through restoration of limb functions and also to enable nursing care to be performed in palliative management. The choice of treatment method depended on: location of metastasis, degree of bone tissue destruction, type of primary tumour, progression of malignant process and technical resources. Within the long bones intramedullary nails (189) of different generations were implanted. In the proximal part of femoral bone various types of endoprostheses (65) were used, enabling oncological radicalism and early rehabilitation of the patients.
Results. Resection of bones with neoplasm-induced lesions, filling the lesion with bony cement and stabilisation with blocking nails permitted early rehabilitation of patients. In our material the most common malignancies inducing metastases were: breast, kidney, lung cancers and myeloma. Patients with these neoplasms constituted nearly 74% of all hospitalised subjects.
Conclusions. Necessity of systemic management and importance of early surgical treatment of metastases in specialized centres were underlined. 相似文献
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同种异体骨材料复合自体浓缩红骨髓移植治疗良性骨肿瘤和瘤样病变 总被引:1,自引:0,他引:1
背景:同种异体骨足临床常用的骨移植材料,但缺乏诱导成骨能力是最人的问题.目的:评价良性骨肿瘤及瘤样病变刮除或切除后应用同种异体骨复合白体红骨髓修复骨缺损的效果.设计、时间及地点:回顾性病例对比分析,于2004-05/2006-05在华中科技人学同济医学院附属同济医院骨科进行.对象:选择良性骨肿瘤及瘤样病变108例患者,男58例,女50例:年龄10-58岁,平均32岁.其中采用异体骨复合自体浓缩红骨髓植骨52例(复合红骨髓植骨组);单纯异体骨植骨56例(单纯植骨组).方法:复合红骨髓植骨组惠者根据预计植骨量从每位患者两侧的骼前上棘或髂后上棘抽取红骨髓40~100 mL,在植骨前将同种异体骨与红骨髓充分混匀.肿瘤刮除或切除后,用电刀烧灼骨缺损腔,将同种异体骨剪成细小的短棒状或修成2 mm见方的块状,植入骨缺损区内.单纯植骨组将相同比例的生理盐水与同种异体骨充分混匀后植入骨缺损区内.主要观察指标:术后定期进行植骨区X射线检查及骨密度检测,比较两组间移植骨颗粒界限模糊、消失的时间及不同时间骨密度的情况.同时观察术后并发症如免疫排斥反应、感染等发生情况.结果:100例患者达骨性融合(复合红骨髓植骨组49例,单纯植骨组51例),并获得24个月随访,数据进入结果分析.复合红骨髓植骨组移植骨界限模糊时间和消失时间均短于单纯植骨组(P<0.05~0.01).术后3,6,12个月时复合红骨髓植骨组骨密度高于单纯植骨组(P<0.05~0.01).复合红骨髓植骨组2例,单纯植骨组3例出现排异反应,使用免疫抑制剂治疗两三周后痊愈.结论:同种异体骨复合自体红骨髓米源相对丰富,抗原件减弱,能明显促进骨融合和骨缺损的愈合. 相似文献