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本科自1990年1月～1996年6月收治四肢骨肿瘤患者92例(未治疗者不计在内),其中7例进行瘤段切除,骨缺损处用自体腓骨或人工假体替代,这样既消除了肿瘤引起的肢体疼痛,又保留了肢体形态及关节功能。现报告如下: 1 临床资料 1.1 一般资料 本组患者中,男5例,女2例;年龄为29～60岁,平均43岁;病程2～30个月,平均7.5个月;均无家族类似病史。部位:桡骨下段2例,肱骨干1例,股骨上段(端)4例,肿瘤性质:骨巨细胞瘤Ⅱ～Ⅲ级3例,软骨肉瘤1例,骨肉瘤并恶性纤维组织细胞瘤1例,转移性腺癌2例,均经病理学、电镜、免疫组化检查证实而确诊;从活检到行肿瘤段切除间隔1～30天,(其中1例由外院活检后转入我科),平均间隔19天。 1.2 治疗及结果 对本组7例患者均进行了保肢治疗,减轻了肢痛,且患者对保留肢体的形态及关节功能均满意。其中有2例转移性腺癌患者于术前,术后均进行了化疗,但患者均拒绝肺癌原发灶的手术治疗且坚决要求保肢;2例桡骨下段骨巨细胞瘤患者肿瘤段切除后,以自体健侧腓骨移植替代了患侧,下尺、桡关节重建术,(1例术后2年替代腓骨局部复发,经局部刮除及用碘酒、酒精烧灼后至今已2年余未见复发)。
In the undergraduate course, 92 patients with bone tumors of limbs were treated from January 1990 to June 1996 (excluding untreated patients). Seven of them were treated with tumor resection. The bone defect was replaced with autologous iliac bone or artificial prosthesis. The tumor caused by limb pain, but also retained the limb morphology and joint function. The report is as follows: 1 Clinical data 1.1 General information In this group of patients, 5 males and 2 females; aged 29 to 60 years, mean 43 years; duration of 2 to 30 months, an average of 7.5 months; no family similar History. Site: 2 cases of lower humerus, 1 case of humeral shaft, 4 cases of upper femur (end), tumor nature: 3 cases of II-III grade of giant cell tumor of bone, 1 case of chondrosarcoma, 1 case of malignant fibrous histocytoma of osteosarcoma, Two cases of metastatic adenocarcinoma were confirmed by pathological examination, electron microscopy, and immunohistochemical examination. From biopsy to resection of the tumor, the interval was 1 to 30 days (one of them was transferred to our department after biopsy in the other hospital). 19 days. 1.2 Treatment and results Limb salvage treatment was performed on 7 patients in this group, which reduced limb pain, and patients were satisfied with the shape and joint function of the preserved limbs. Among them, 2 patients with metastatic adenocarcinoma received chemotherapy before and after surgery. However, all patients refused surgical treatment of the primary tumor of the lung cancer and strongly demanded limb salvage; 2 patients with giant cell tumor of the lower humerus were treated with tumor resection. The ipsilateral ipsilateral iliac bone graft was used to replace the ipsilateral, lower ulnar, and ankle joint reconstruction. (One patient had partial recurrence of the humerus after 2 years of surgery. After partial curettage and after burning with iodine and alcohol, it has not been seen for more than 2 years. relapse).