目的：探讨半侧骨皮质切除灭活再植术治疗四肢低度恶性骨肿瘤的疗效。方法：回顾性研究2005年1月至2011年1月行半侧骨皮质切除灭活再植术治疗四肢低度恶性骨肿瘤患者10例，年龄(27.0±6.5)岁。病理检查显示骨旁骨肉瘤7例，骨膜软骨肉瘤3例；按照Enneking方法分期，IA期8例，IB期2例。结果：本组病例术后都得到随访，随访时间为(50±23)月，骨折断端都达到了骨性愈合。瘤段骨切除长度为(9.5±2.7) cm，手术时间为(150±45)min，出血量为(1000±350) mL，术后48 h内拔除引流管，引流量为(450±200) mL。术中1例(10.0%)患者出现残存骨骨折，及时予以钢板螺钉内固定。1例(10.0%)患者出现局部复发，予以扩大切除人工关节置换术，无远处转移。根据Enneking等肢体肌肉骨骼肿瘤外科治疗重建术后功能评估标准，功能评定优9例，良1例。结论：半侧骨皮质切除治疗骨表面低度恶性骨肿瘤安全有效。%Objective: To treat low-grade limb malignant tumors with hemicortical excision and reconstruction of the defect with recycled pasteurized autogratf. Methods:From January 2005 to January 2011, 10 patients [age (27.0±6.5) years] suffering from low-grade limb malignant tumors were treated with hemicortical excision and reconstruction of the defect with recycled pasteurized autogratf:7 were histopathologically diagnosed as parosteal osteosarcoma, and 3 as peripheral chondrosarcoma. According to the Enneking staging system, 8 were in Stage IA and 2 were in IB. Results:All the patients were followed-up for (50±23) months. All the patients had bony union at the last follow-up. The length of tumor bone resection was (9.5±2.7) cm, operation time was (150±45) min, intraoperative blood loss was (1000±350) mL, and drainage volume was (450±200) mL. hTe only fracture in the host bone during the operation was treated by internal ifxation. Local recurrence occurred in 1 patient was treated by a wide operative margin and reconstruction with a prosthesis. There was no distal metastasis. A ccording to the Enneking system, 9 patients had excellent results and 1 had good results. Conclusion:Hemicortical excision for low-grade limb malignant tumors is safe and effective.
展开▼
