关节囊外整块切除保留胫骨骨骺可延长肿瘤型假体治疗儿童股骨远端骨肉瘤
张岩;刘涛;李甲振;卢新昌;张翼;
摘要(Abstract)：
[目的]对儿童股骨远端骨肉瘤(San-Julian分型III型)行关节囊外整块切除联合使用保留胫骨骨骺可延长肿瘤型人工关节假体重建术的早期临床研究。[方法] 2017年10月～2018年10月,共6例患儿在本院行穿刺活检病理学证实为骨肉瘤,影像学分型,均为San-Julian分型III型,其中男2例,女4例;年龄7～12岁;左侧3例,右侧3例。均在本科接受关节囊外整块切除联合保留胫骨骨骺可延长肿瘤型人工假体重建术,术后指导患儿进行功能锻炼,伤口2周后拆线,再过1周后即给予术后的规范化化疗,并进行随访。[结果] 6例患儿手术时间分别为2.5 h、3 h、3 h、3.2 h、3.5 h和4 h,平均(3.20±1.14) h;术中出血量600～1 200 ml,平均(850.00±484.77) ml。6例患儿均获随访9～21个月,平均(15.17±9.53)个月。根据美国骨肿瘤学会评分系统(Musculoskeletal Tumor Society, MSTS),术后3个月功能评分18～27分,平均(22.83±7.67)分,患儿肢体功能达到良好标准。末次随访,患肢膝关节屈曲角度90°～110°共4例,110°～130°共2例,伸直均能达到180°;共5例患儿双下肢长度相差<1.5 cm,1例患儿双下肢长度差异约为2.5 cm。随访期间所有患儿均未出现局部复发及肺部转移。[结论]通过严格把握手术适应证,对于股骨远端骨肉瘤San-Julian分型中的III型的患儿,关节囊外切除联合使用保留胫骨骨骺可延长肿瘤型人工关节假体重建术提供了一种安全有效的手术方式。
关键词(KeyWords)： 关节囊外切除;骨肉瘤;胫骨骨骺;可延长假体
基金项目(Foundation):
作者(Author): 张岩;刘涛;李甲振;卢新昌;张翼;
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DOI:
参考文献(References)：
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