半骨盆置换术治疗骨盆恶性肿瘤的中远期随访
孙伟;马小军;张帆;蔡郑东;
摘要(Abstract)：
[目的]探讨半骨盆置换术在骨盆恶性肿瘤广泛切除和功能性保肢手术中的应用。[方法]回顾本科自2003～2007年16例半骨盆切除和重建手术治疗案例,评估骨盆恶性肿瘤广泛切除和假体置换术的疗效和并发症。[结果]16例骨盆原发性恶性骨肿瘤患者,接受了骨盆肿瘤切除和计算机辅助定制人工半骨盆假体置换手术。患者平均年龄为27岁,病理类型包括4例骨肉瘤、6例软骨肉瘤、3例骨巨细胞瘤、1例尤文肉瘤和2例纤维肉瘤,外科分期为ⅡB。术前评估包括:MRI、ECT全身骨扫描、肺部CT、肿瘤穿刺活检及动脉血管造影并根据病理结果部分行动脉灌注化疗,广泛切除骨盆肿瘤,安装定制人工半骨盆假体。术中平均出血2 600 ml(1 200～8 500 ml)。5例有伤口并发症,脱位3例。中位随访时间36个月(23～62个月),3例局部复发行局部切除放疗,4例死于原发肿瘤远处转移,MSTS功能评分平均72%。[结论]在骨盆原发性恶性肿瘤的治疗中,合理的广泛切除是治愈肿瘤的关键,应用计算机辅助半骨盆假体置换能快速、有效重建骨骼缺损,原发肿瘤对化疗及放疗的敏感性及肿瘤的性质是决定预后的主要原因,伤口并发症及脱位是其主要并发症,患者心理满意度较高,患肢功能可以接受。
关键词(KeyWords)： 骨盆;肉瘤;保肢手术
基金项目(Foundation):
作者(Author): 孙伟;马小军;张帆;蔡郑东;
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DOI:
参考文献(References)：
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