髋关节置换术与经皮骨水泥填充术治疗股骨近端转移瘤效果的比较研究

目的研究髋关节置换术与经皮骨水泥填充术治疗股骨近端转移瘤的临床效果。方法回顾性分析河北医科大学附属第四医院2011年6月～2012年6月收治的股骨近端转移瘤患者39例,随机分成两组,对照组20例行人工髋关节置换术,治疗组19例行经皮骨水泥填充术。术后3个月开始随访,对两组手术指标、手术前后疼痛及Charnley髋关节评分进行比较。结果①两组患者手术均顺利完成,其中治疗组手术时间[（36.70±6.67）min]、术中出血量[（33.00±8.16）mL]及术后卧床时间[（6.80±0.83）d]均明显少于对照组[（97.30±10.52）min、（228.00±61.47）mL、（8.00±0.67）d],差异有统计学意义（P〈0.05）。②两组患者均顺利完成术后定期随访,未发生失访。两组患者视觉模拟评分法（VAS）评分在术后3、6个月均明显低于术前,差异均有统计学意义（P〈0.05）;两组术后3、6个月VAS评分差异无统计学意义（P〉0.05）。两组患者Charnley髋关节评分在术后3、6个月均明显低于术前,差异均有统计学意义（P〈0.05）;两组术后3、6个月Charnley髋关节评分差异无统计学意义（P〉0.05）。结论经皮骨水泥填充术应用于股骨近端转移瘤不失为一种简单、有效的方法。

Comparative study on hip arthroplasty and percutaneous bone cement augmentation in the treatment of proximal femoral metastases

Objective To evaluate the clinical comparison of percutaneous osteoplasty and artificial hip prosthesis in treatment of metastatic tumors involving the proximal femur. Methods 39 patients with metastatic tumors involving the proximal femur in the Fourth Affiliated Hospital of Hebei Medical University from June 2011 to June 2012 were selected retrospectively and divided into two groups randomly. 20 cases in control group were treated with artificial hip prosthesis,19 cases in treatment group were treated with percutaneous osteoplasty. All the patients were followed up since 3 months after the operation. Operation indexes,pain before and after surgery,Charnley hip score between the two groups were compared. Results ①All the operations were achieved successfully; operation time,intraoperatve blood soss,the postoperative recovery time in treatment group [（36.70±6.67） min,（33.00±8.16） mL,（6.80±0.83） d] were all lower than those in control group [（97.30±10.52） min,（228.00±61.47） mL,（8.00±0.67） d],the differences were statistically significant（P〈 0.05）. ②All the follow-up visits were achieved successfully. VAS scores for 3,6 months after the operation in the two groups were lower than those before the operation,the differences were statistically significant（P 〈0.05）; the differences of VAS scores for 3,6 months after the operation between the two groups were not statistically significant（P 〈0.05）. Charnley hip scores for 3,6 months after the operation in the two groups were lower than those before the operation,the differences were statistically significant（P 0.05）; the differences of Charnley hip scores for 3,6 months after the operation between the two groups were not statistically significant（P 0.05）. Conclusion Percutaneous osteoplasty in treatment of metastatic tumors involving the proximal femur is an simple and effective method.