人工假体置换治疗髋部恶性骨肿瘤.docVIP

人工假体置换治疗髋部恶性骨肿瘤 李东升， 冯 峰 ，古建立 ， 张志勇， 郭建刚 ， 黄满玉﹡ 摘要 目的 探讨应用人工假体置换治疗髋部恶性骨肿瘤的手术方法和疗效。方法 应用人工假体置换治疗髋关节部位恶性肿瘤 14例，其中股骨上端假体置换12例，半骨盆假体置换2例。结果 获随访１１例，随访时间14 ～86个月，平均4４个月。股骨假体置换病例中，术后肿瘤局部复发１例，无假体松动、术后感染病例；人工半骨盆置换２例中，术后发生松动，髋关节脱位1例，术后感染1例。术后1年内死亡2例，2年内死亡3例，3年内死亡２例，余４例髋关节功能良好，其中３例能不借助拐杖行走，１例需扶拐行走。结论 股骨近端恶性肿瘤,特别是转移瘤并发骨折，人工假体置换术可立刻恢复骨骼的连续性及关节功能，效果良好；髋臼部恶性肿瘤切除后人工假体置换并发症较多，临床应用需慎重。 关键词：股骨，骨盆，骨肿瘤，关节成形术，置换，髋 中图分类号 R738.1；R687.42 The treatment of prosthesis replacement of hip after resection of malignant tumors LI Dong-sheng, FENG Feng, GU Jian-li, ZHANG Zhi-yong, GUO Jian-gang, HUANG Man-yu ( Dept of bone tumor of Luoyang orthopaedics hospital, Luoyang ,Henan 471002,china ) Abstract Objective To study the operative methods and effects of prosthesis replacement of hip joint with malignant tumor. Methods There were 14 cases with the treatment of hip prosthesis replacement to be reviewed during the study in our hospital, including 12 cases with prosthesis replacement of proximal femur, 2 cases with hemipelvectomy. Results There were 11 cases in all followed up from 14 to 86 months with mean 44 months. No one case with infection or loosening screws of the fixation except with 1 case with local recurrence in the 12 cases of prosthesis replacement of proximal femur, while in the other 2 cases with hemipelvectomy, there 1 case with loosening screws and 1 case with infection occurred. 4 patients acquired satisfactory function of hip and 7 cases in all died in 3 years after operation. Conclusion According to this review study, prosthesis replacement to treat the malignant tumor of proximal femur especially with fracture is the good choice with short therapeutic process and good results with the advantage of providing strong support, stabilizing the joint, while the method of hemipelvectomy for the malignant tumor of acetabulum should be caution because they might have more complication in the future. Key words femur, pelvis, bone neoplasms, arthroplasty, replacement, hip 髋关节部位(