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定制人工假体置换治疗股骨近端骨肿瘤 总被引:1,自引:1,他引:0
目的评价定制人工假体置换治疗股骨近端骨肿瘤的疗效。方法对股骨近端骨肿瘤30例行瘤段切除、定制人工假体置换治疗。其中21例行加长柄双动性股骨头置换,9例行加长柄全髋置换。术后6个月功能评价采用MSTS 93评分。结果 30例均获随访,时间12~36个月。无感染、假体松动、假体脱位、假体周围骨折等并发症发生。术后6个月MSTS 93评分平均为(26.0±2.14)分;肢体功能:优15例,良12例,中3例,优良率为90%。2例于术后13、15个月死亡。结论定制人工假体置换是治疗股骨近端骨肿瘤的有效方法,术后髋关节功能良好。 相似文献
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特制人工假体在骨肿瘤保肢治疗中的应用 总被引:2,自引:0,他引:2
[目的]在新辅助化疗前提下,探讨肢体骨肿瘤切除术后骨缺损的修复途径.[方法]收治36例病人,骨肉瘤经过新辅助化疗,术前确定切除范围,订做特制人工假体,行肿瘤切除假体置换术.[结果]5个人工骨盆,经过6个月~8 a的随访,现功能良好.24例恶性骨肿瘤患者,6例死亡,5 a以上存活率为58.3%,晚期人工关节松动下沉2例,柄部折断1例,经翻修后好转.[结论]特制人工假体在骨肿瘤切除术后骨缺损修复方面有其独特的优越性. 相似文献
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目的探讨人工间置型假体置换治疗长骨骨干恶性肿瘤的手术方法与疗效。方法 2008年6月-2010年6月,4例长骨骨干恶性肿瘤患者于我院接受骨干瘤段切除人工间置型假体置换手术。4例均为男性,年龄24~60岁,平均41岁。其中股骨干恶性纤维组织细胞瘤1例,肺癌单发股骨干转移瘤1例,软组织腺泡状肉瘤胫骨干转移瘤1例,肾癌单发肱骨干转移瘤1例。结果获得随访16~40个月。截止末次随访时,4例患者患肢功能良好,MSTS评分平均为28.3分(27~30分)。均无局部复发。其中3例无瘤生存;1例胫骨干转移瘤患者术前已有肺转移,术后9个月出现脑转移,目前带瘤存活。结论肿瘤瘤段截除人工间置型假体置换术是治疗长骨骨干恶性肿瘤的有效术式之一,该术式能够达到安全的外科边界,降低局部复发率,并保留良好的肢体功能。 相似文献
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人工假体置换治疗髋部恶性骨肿瘤 总被引:1,自引:1,他引:0
目的 探讨应用人工假体置换治疗髋部恶性骨肿瘤的手术方法和疗效。方法应用人工假体置换治疗髋关节部位恶性肿瘤14例.其中股骨上端假体置换12例.半骨盆假体置换2例。结果 获随访11例,随访时间14~86个月,平均44个月。股骨假体置换12例中失访3例,术后肿瘤局部复发1例,无假体松动、术后感染病例;前骨盆置换2例中.术后发生松动.髋关节脱位1例,术后感染1例。术后1年内死亡2例,2年内死亡3例.3年内死亡2例;余4例髋关节功能良好.其中3例能不借助拐杖行走,1例需扶拐行走。结论股骨近端恶性肿瘤,特别是转移瘤并发骨折.人工假体置换术可立刻恢复骨骼的连续性及关节功能,效果良好;髋臼部恶性肿瘤切除后人工假体置换并发症较多,临床应用需慎重。 相似文献
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人工假体置换在膝关节周围侵袭性骨肿瘤中的应用 总被引:5,自引:1,他引:4
目的: 探讨人工假体在膝关节周围原发侵袭性骨肿瘤保肢术中的临床应用效果。方法: 膝关节周围原发侵袭性骨肿瘤患者 42例。其中股骨远端 24例, 胫骨近端 16例, 腓骨上端 2例。病理类型: 骨肉瘤 21例, 骨巨细胞瘤 (Ⅱ~Ⅲ级) 16例, 软骨肉瘤 4例, 滑膜肉瘤 1例。行骨肿瘤的广泛切除或根治性切除后, 采用人工膝关节假体置换重建, 对骨肉瘤患者同时采用新辅助化疗治疗。结果: 42例患者术后随访 12~72个月, 其中 30例患者无局部复发或远处转移, 12例出现复发。膝关节活动范围: 伸 0°, 屈 85 ~120°。按Enneking法评定功能, ≥23分 22例, 15~22分 17例, <15分 3例, 优良率达到 86%。结论: 人工假体是一种治疗膝关节周围恶性骨肿瘤较好的保肢方法, 能降低局部并发症及提高临床疗效。 相似文献
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目的总结全股骨人工假体置换保肢术的方法与疗效。方法2003年8月-2006年6月,收治3例股骨干ⅡB期肿瘤患儿。男2例,女1例;年龄12~15岁。骨肉瘤2例,尤文肉瘤1例。MRI检查示肿瘤侵袭范围超过股骨全长2,3。采用全股骨切除后人工全股骨假体置换保肢术为主的综合治疗。术后2例进行定期化疗。结果患儿均获随访,随访时间12~52个月,平均36个月。无并发症发生。术后12个月按照国际保肢协会标准评估肢体功能,髋关节和膝关节功能为优,生活基本自理。2例采用非可延长型假体置换的患儿患肢分别短缩1.5cm和2.5cm;1例采用Stanmore型螺杆驱动式可延长假体置换的患儿,术后延长假体4次,共延长6.0cm,患肢功能良好。结论对于股骨受到肿瘤广泛破坏的患者,应用人工全股骨假体修复重建全股骨切除后的骨关节缺损,是一种可供选择的治疗方法。 相似文献
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Resection followed by vascularized bone autograft in patients with possible recurrence of malignant bone tumors after conservative treatment 总被引:1,自引:0,他引:1
J P Metaizeau D Olive P Bey P Bordigoni F Plenat J Prévot 《Journal of pediatric surgery》1984,19(2):116-120
In conservative treatment of malignant bone tumors, assessment of the local condition is difficult. The radiological changes seen in the irradiated tumor and the frequent occurrence of pathological fractures at this site may give rise to the fear that the tumor has relapsed. Resection of the whole of the involved bone is the best way to assure adequate local control but the extent of the bone defect and the bad local conditions secondary to irradiation make reconstruction hazardous. In two patients (one with Ewing's sarcoma of the femur and one with osteogenic sarcoma of the humerus) the authors used a free, vascularized fibular graft for the reconstruction having obtained consolidation of the limb after resection of the irradiated tumor, with preservation of its function. The encouraging results obtained have suggested a conservative attitude as primary treatment of specific malignant bone tumors. 相似文献
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Ryohei Yokoyama Yasuo Beppu Ken-ichi Tobisu Yoshihiro Moriya Kiyotaka Uchiyama Masashi Kito Toru Umeda Tadashi Hasegawa Tadakazu Shimoda 《Journal of orthopaedic science》2000,5(5):449-456
The prognosis for malignant pelvic bone tumors is worse than that for malignant bone tumors of the extremities because definitive
surgery in the pelvis is often difficult to accomplish. The results for eight patients who were treated consecutively with
a multidisciplinary approach, from 1990, were analyzed. The histologic diagnosis was osteosarcoma in five patients, chondrosarcoma
in two, and Ewing's sarcoma in one. Five lesions arose in the ilium and three in the pubis. The extraosseous tumors decreased
in size and/or were encapsulated as a result of preoperative chemotherapy in six patients, four of these achieving a wide
surgical margin. With respect to tumor location and surgical margin, all five lesions in the ilium involved the sacrum, four
of these being resected with an inadequate margin. The three lesions in the pubis were resected with an adequate margin. Local
recurrence was observed in two patients who had been treated with an inappropriate margin. During the period between 18 and
57 months after the first operation, five patients were continuously free of disease and one was still alive but had lung
metastases. Our results indicate that a patient's chances of definitive surgery may be enhanced by a multidisciplinary approach,
although the management of sacroiliac involvement remains challenging.
Received: October 4, 1999 / Accepted: March 16, 2000 相似文献
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[目的]探讨应用旋转铰链型人工膝关节置换治疗膝部恶性骨肿瘤的手术方法和疗效。[方法]应用旋转铰链型人工膝关节置换治疗膝部恶性骨肿瘤14例,其中股骨下端9例,胫骨上端5例。[结果]14例均获随访,时间17~65个月,平均44个月,总优良率为85.7%。膝关节活动度:伸0°,屈90°~130°,平均为110°。其中股骨假体置换后活动度平均120°,胫骨假体置换后活动度平均95°。术后肿瘤局部复发1例,假体松动1例,感染1例。[结论]旋转铰链型假体减少了骨与假体之间的应力,大大降低了松动或疲劳折断的发生率,是膝部恶性骨肿瘤较理想的保肢方法。 相似文献
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Muramatsu K Ihara K Doi K Hashimoto T Seto S Taguchi T 《Archives of orthopaedic and trauma surgery》2008,128(10):1017-1021
Introduction Hand reconstruction after wide resection of digital malignant tumors is still very challenging. The technique of adjacent
digital ray transposition has been used for digital defects arising from trauma, but few papers have focused on reconstruction
following resection of malignant tumors of the finger. The indications, complications and functional outcomes with this approach
are discussed.
Patients and methods Four patients underwent primary reconstruction with adjacent digital ray transposition after tumor resection. Two were men
and two were women and the median age was 62 years. The malignant tumors were low-grade chondrosarcomas of the metacarpal
bone in two cases, epithelioid sarcoma at the fingertip in one case and synovial sarcoma at the base of the thumb in the fourth
case.
Results Metacarpal osteotomies were rigidly stabilized with a plate and screws and with an intramedullary bone peg graft. Digit length
and rotation were satisfactory and there were no non-unions. Local recurrence was not observed at the final follow-up. The
mean musculoskeletal tumor society (MTS) score was 60% (range 48–80%). The results of the disabilities of the arm, shoulder
and hand score were similar to the MTS score, with a mean score of 35 points (range 22.5–63.5). The worst result was for index-to-thumb
transposition and the best was for index-to-middle. All patients experienced emotional difficulty with acceptance of a three-finger
hand.
Conclusion Primary reconstruction with digital ray transposition produces acceptable functional outcomes after resection of malignant
tumor. This procedure is best indicated for central single ray amputation but sometimes is associated with esthetical problems. 相似文献
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目的:探讨人工关节在恶性骨肿瘤保肢治疗中的应用疗效。方法:对21例恶性骨肿瘤患者进行人工关节置换保肢治疗,其中铰链式膝关节10例,股骨近端假体5例,人工肱骨头4例,人工肩胛骨1例,人工肘关节1例。结果:随访1~7年,平均4年,局部复发率9.5%,最终保肢率90.5%;所有患者人工关节置入均超过6个月,参照Enneking(MSTS)评定标准,平均得分21.2分,优良率76.2%。结论:人工关节置换术应用于恶性骨肿瘤的保肢治疗可以取得满意的疗效,正确掌握手术适应证、肿瘤的完整切除和软组织重建是手术成功的关键。 相似文献
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目的探讨股骨上段转移性肿瘤定制人工股骨头置换治疗的近期疗效。方法对14例股骨上段转移性肿瘤患者行瘤段骨切除和定制人工股骨头置换手术治疗。肾功能正常患者术后2周开始二膦酸盐类药物口服,并对患者的临床表现、局部影像学、疼痛情况及患侧肢体术后功能进行观察评定。结果术后患髋疼痛基本缓解,关节活动功能恢复满意,可满足日常行走和负重需要。14例均获随访,时间6~38个月。随访期内无假体松动、脱位及假体周围骨折等发生,手术局部肿瘤无复发。术后3个月时髋关节Harris评分:优4例,良9例,可1例。结论对股骨近段转移性肿瘤采用定制人工股骨头重建,可有效缓解疼痛,保留肢体功能,提高生存质量。 相似文献
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目的探讨化疗联合CIK治疗恶性肿瘤的护理干预疗效。方法选取2011年6月~2013年6月我院进行治疗的恶性肿瘤患者69例,随机分为观察组35例和对照组34例。对照组进行常规护理,观察组进行护理干预。观察两组患者的临床疗效、不良反应、护理满意度等。结果观察组总有效率及护理满意度明显高于对照组(P〈0.05),不良反应总发生率显著低于对照组(P〈0.05)。结论对恶性肿瘤患者进行化疗联合CIK治疗的护理干预,可以提高临床疗效,减少不良反应发生,且患者对护理满意度高,值得推广应用。 相似文献