可旋转稳定型假体对胫骨近端恶性骨肿瘤膝关节活动度及临床疗效的影响

目的探讨可旋转稳定型假体对胫骨近端恶性骨肿瘤膝关节活动度及临床疗效的影响效果。方法选择2012年5月至2013年5月间收治的68例胫骨近端恶性骨肿瘤患者,随机分为可旋转稳定型假体组(简称观察组),以及单纯铰链型假体组(简称对照组),评估两组患者的膝关节功能、疼痛缓解程度和并发症情况,随访1年评价生活质量。结果观察组患者的优良率为94.1%,优于对照组优良率(88.2%),差异有统计学意义(P<0.05)。观察组伸直(136.2±14.6)度,对照组伸直(110.4±13.2)度,差异有统计学意义(P<0.05)。术前两组患者VAS评分比较,差异无统计学意义(P>0.05)。观察组视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。观察组患者出现并发症2例,对照组出现并发症3例,差异无统计学意义(P>0.05)。观察组的生活质量指标PF、RP、RE得分均高于对照组,差异有统计学意义(P<0.01)。结论胫骨近端恶性骨肿瘤治疗中应用可旋转稳定型假体,不仅可有效改善患者的膝关节活动度,提高临床疗效,而且可改善患者的生活质量,具有较好的临床推广价值。

Analysis of knee joint motion range of spin stabilized prosthesis on proximal tibial malignant tumor and its clinical curative effect

Objective To discuss knee joint motion range of spin stabilized prosthesis on proximal tibial malignant tumor and its clinical curative effect analysis.Methods Selected 68 cases proximal tibial malignant tumor patients who were treated in our department,randomly divided them into spin stabilized prosthesis group（ short for observation group）,and simple hinge prosthesis group（ short for control group）,evaluated two group patients＇ knee joint function,pain relief,complications and followed up 1 year their lives qualities.Results Observation group patients＇ excellent rate were 94.12%,better than control group＇s 88.24%,the differences had statistical significances（ P〈 0.05）; and observation group＇s patients could strength（ 136.2 ± 14.6） °,higher than control group patients＇（ 110.4 ± 13.2） ° the differences had statistical significances（ P〈 0.05）.Before operation compared two group patients＇ Visual Analogue Scale（ VAS） scores,hadn＇t statistical significances（ P〉0.05）; after operation followed up 6 months,observation group＇s VAS score lower than control group,the differences had statistical significances（ P〈 0.05）.In observation group 2 cases（ 5.88%） appeared complication,lower than control group＇s 3 cases（ 8.82%）,the differences hadn＇t statistical significances（ P〉 0.05）.Two groups both followed up 6 and 12 mo,observation group＇s life quality index physical functioning（ PF）,role physical（ RP）,role-emotional（ RE）score all higher than control group,the differences had statistical significances（ P〈 0.01）.Conclusion Apply spin stabilized prosthesis on proximal tibial malignant tumor treatment not only can effectively improve patients＇ knee joint motion range,improve clinical curative effect; but also can improve patients＇ life quality,had good clinical promotion means.