保留骨骺灭活再植术治疗儿童股骨远端骨肉瘤Inactivated bone replantation with preservation of the epiphysis for osteosarcoma in children
于秀淳;刘晓平;周银;付志厚;宋若先;孙海宁;徐明;
摘要(Abstract):
[目的]探讨保留骨骺灭活再植术的临床应用注意事项及并发症的防治。[方法]回顾6年间所治疗的11例患者,男5例,女6例。平均年龄7.6岁。均位于股骨下端。MRI分型:Ⅰ型7例,Ⅱ型4例。1例合并病理骨折。治疗方法均采用术前化疗2疗程+保留骨骺灭活再植手术+术后化疗。[结果]手术时间为3~4 h。术中出血量为300~500 ml。无血管、神经损伤。术后切口一期愈合,无切口感染及切口延迟愈合。11例获得随访10~72个月,患膝屈曲>110°3例,90°~110°3例,60°~89°4例,<60°1例。下肢等长4例,患肢较健侧短<2 cm 5例,2~3cm 2例。复发1例,转移2例,死亡3例,螺钉松动1例,灭活骨骨折1例。[结论]保留骨骺灭活再植术有利于术后功能恢复和肢体长度的保持;严格无瘤及无菌操作、彻底引流、适当延长外固定的时间、功能锻炼时注意保护肢体等是预防并发症发生的主要措施。
关键词(KeyWords): 保留骨骺灭活再植术;骨肉瘤;并发症
基金项目(Foundation):
作者(Author): 于秀淳;刘晓平;周银;付志厚;宋若先;孙海宁;徐明;
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DOI:
参考文献(References):
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