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目的探讨四肢转移性瘤手术治疗的方法与疗效。方法 2000年6月至2007年6月明确诊断的96例四肢骨转移性肿瘤患者中,32例接受外科手术治疗,其中人工关节置换14例,异体骨加带锁髓内钉内固定10例,骨水泥加带锁髓内钉内固定5例,骨水泥加钢板内同定2例,异体骨加钢板内固定1例。结果术中顺利,术后无感染。32例患者随访3—60个月,平均36个月。1例股骨中段异体骨植骨加髓内钉内固定于术后3个月出现内固定松动,12例异体骨移植患者中,3例在随访结束时移植骨与宿主骨未达到骨性愈合,但不影响功能。所有患者术后疼痛得到明显缓解,Enneking评分:功能为优78.2%,中16.8%,差5.0%。患者2年生存率为34.6%,5年生存率为16.7%。结论手术治疗四肢转移性肿瘤可以有效缓解疼痛、预防病理性骨折的发生、改善肢体功能及提高患者的生存质量。
Objective To investigate the surgical treatment of metastatic limbs and limbs. Methods From June 2000 to June 2007, 96 cases of extremity bone metastases with definite diagnosis were treated by surgical operation. Among them, 14 cases were treated by artificial joint replacement, 10 cases were treated by allogeneic bone and interlocking intramedullary nailing, Five cases of internal fixation with bone cement and intramedullary nailing, two cases of internal fixation with bone cement and steel plate, and one case of allogenic bone plus plate fixation. Results of surgery smoothly, no postoperative infection. 32 patients were followed up for 3-60 months, an average of 36 months. One case of allogeneic bone graft with bone graft and intramedullary nailing within 3 months after operation showed internal fixation loosening. Of the 12 patients with allogeneic bone graft, 3 cases did not reach the bony union at the end of follow-up, But does not affect the function. Postoperative pain was relieved in all patients. The Enneking score was 78.2% for excellent, 16.8% for moderate, and 5.0% for poor. Patients 2-year survival rate was 34.6%, 5-year survival rate was 16.7%. Conclusion Surgical treatment of limb metastatic tumors can effectively relieve pain, prevent the occurrence of pathological fractures, improve limb function and improve the quality of life of patients.