抗感染骨肿瘤假体设计及其在保肢术中的应用

目的：研究抗感染骨肿瘤假体的设计方案，并分析其在保肢术中的应用效果。方法：以2010年4月至2012年4月间行骨肿瘤切除、人工假体置换重建骨缺损的61例保肢术患者为研究对象，征得患者同意，对其中33例患者的假体行抗感染涂层设计，于假体表面涂布抗生素骨水泥，将其归入观察组；其余28例假体不做特殊处理，将其归入对照组。随访24个月，统计假体周围感染、肿瘤复发、远隔转移等并发症、肢体功能恢复情况及截肢率，进行对比。结果：随访期间，观察组无假体周围感染病例，对照组出现4例，差异具备统计学意义（P <0.05）；观察组肿瘤复发2例，远隔转移1例，对照组肿瘤复发3例，远隔转移1例，差异无统计学意义（P >0.05）；随访结束时，观察组 MSTS93评分为（25.4±4.1）分，对照组为（18.9±3.1）分，差异具备统计学意义（P >0.05）；观察组随访期间截肢2例，对照组截肢4例，差异不具备统计学意义（P >0.05）。结论：以抗生素骨水泥作为表面涂布剂，获得的骨肿瘤假体在控制假体周围感染方面优势显著，能有效提升患者预后，具备推广价值。

Resistance to infection of bone tumor prosthesis design and its application in limb - sal-vage surgery

Objective:To study the resistance to infection of bone tumor prosthesis design,and analyzes its appli-cation effect in limb salvage surgery. Methods:Bone tumor resection,artificial prosthesis replacement reconstruction of bone defect 61 limb - salvage surgery patients were selected as the research object,the other 33 cases as observation group. Results:During follow - up,the observation group had no surrounding prosthesis infection in 4 cases,control group,the differences had statistical significance(P < 0. 05);Observation group tumor recurrence in 2 cases,1 case of far transfer,the control group(3 cases),tumor recurrence far transfer in 1 case(P > 0. 05). At the end of follow- up,the observation group(25. 4 ± 4. 1)points for MSTS93 score,control group is(18. 9 ± 3. 1)points(P <0. 05). Conclusion:The bone cement as surface coating agents,with antibiotics for bone tumor prosthesis advantage significantly control infection around the prosthesis,effectively improve patient outcome.