术后切口感染能延长骨肉瘤患者的生存期吗?Can postoperative deep infections prolong survival time of osteosarcoma patients?
陈宇;许宋锋;徐明;于秀淳;
摘要(Abstract):
[目的]探讨保肢手术后切口深部感染对骨肉瘤患者生存的影响。[方法]回顾分析125例骨肉瘤患者临床资料,平均随访期为(5.1±3.9)年(0.5~19.8年),对所得临床资料进行数据分析,并复习相关文献。[结果]共6例患者(4.8%)发生切口深部感染,无全身感染病例。感染和非感染患者接受化疗方案(P=1.00)及对化疗反应(P=0.65)的差异无统计学意义。感染组患者胫骨上段肿瘤较常见(4例,66.6%,P=0.04),且多需截肢治疗(4例,66.6%,P=0.00)。感染患者肿瘤转移率(P=0.03)及死亡率(P=0.00)低于非感染者,差异具有统计学意义,生存分析提示感染组5年生存率及无瘤生存率均为100%,非感染组5年生存率及无瘤生存率分别为54%及43%。Log rank检验揭示感染患者总生存率(P=0.01)及无瘤生存率(P=0.01)均高于非感染者,差异具有统计学意义。COX回归分析提示肿瘤远处转移是患者预后的独立危险因素(P=0.00,95%CI 1.59~3.98)。[结论]保肢手术后感染可能对骨肉瘤患者预后产生积极影响,其机制可能是感染通过炎症免疫反应抑制肿瘤生长,具体的机制尚须进一步阐明,并在此基础上拓展骨肉瘤综合治疗的新方法,以期改善骨肉瘤患者的预后。
关键词(KeyWords): 骨肉瘤;保肢手术;术后感染;生存
基金项目(Foundation):
作者(Author): 陈宇;许宋锋;徐明;于秀淳;
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参考文献(References):
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