[1]曾海涛 王华斌△ 刘远翔 王翔.补片技术在肿瘤关节置换中的应用12例[J].中国中医骨伤科杂志,2021,29(09):58-61.
　ZENG Haitao WANG Huabin LIU Yuanxiang WANG Xiang.Application of Patch Technique in Tumor JointReplacement: A Report of 12 Cases[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(09):58-61.
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补片技术在肿瘤关节置换中的应用12例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年09期
页码:
58-61
栏目:
临床报道
出版日期:
2021-09-15

文章信息/Info

Title:
Application of Patch Technique in Tumor JointReplacement: A Report of 12 Cases
文章编号:
1005-0205(2021)09-0058-04
作者:
曾海涛1 王华斌1△ 刘远翔1 王翔1
1湖北省肿瘤医院骨软组织外科(武汉,430079)
Author(s):
ZENG Haitao1 WANG Huabin1△ LIU Yuanxiang1 WANG Xiang1
1Department of Bone and Soft Tissue Surgery,Hubei Cancer Hospital,Wuhan 430079,China.
关键词:
补片;  关节置换;  肿瘤;  疗效
Keywords:
mesh;  endoprosthetic replacement;  bone tumor;  efficacy
分类号:
R738.1
文献标志码:
A
摘要:
目的:探讨肿瘤型人工关节置换联合补片技术在不同部位关节功能重建中的应用效果、特点及差异。方法:收集2014年1月至2020年12月接受肿瘤型关节置换患者的基线资料,术中行肿瘤扩大切除及人工假体置换并联合应用人工补片进行重建。12例患者入选,随访时间3～28个月。分析各部位手术时间、出血量、引流管拔管时间、术后肢体功能及并发症情况等。采用肌肉骨骼肿瘤学会(Musculoskeletal Tumor Society,MSTS)评分(总分30分)评估术后肢体功能。结果:所有手术患者均顺利完成肿瘤整块切除及重建,骨性重建包括组配式假体重建、定制式假体重建、3D打印假体重建,软组织重建包括肌瓣转位重建、人工补片重建等。不同部位手术在手术时间、出血量方面差异无统计学意义(P>0.05); 拔管时间方面肩关节组优于膝关节组,差异有统计学意义(P<0.05); 肢体功能评分方面,中位MSTS评分为(24.08±2.50)分,MSTS评分优良率达100%,膝关节组和肩关节组MSTS评分明显优于半骨盆组,差异有统计学意义(P<0.05)。术后并发症方面,1例患者出现关节脱位。结论:人工补片在肿瘤关节置换术中有较高的安全性及实用性,利用人工补片技术较好地保留了肿瘤关节患者保肢术后肢体功能,补片技术在肿瘤关节患者保肢治疗中具有良好的安全性及临床应用价值,但对于大范围软组织缺损,应用存在一定局限性。
Abstract:
Objective:To explore the application,characteristics and differences of tumor type artificial joint replacement combined with patch technique in joint functional reconstruction of different parts.Methods:The baseline data of patients with tumor type joint replacement from January 2014 to December 2020 were collected.Patients underwent intraoperative extended tumor resection and artificial prosthesis replacement combined with artificial patch for reconstruction.Finally,12 patients were selected.The follow-up period was 3 to 28 months.The operation time,blood loss,extubation time,postoperative limb function and complications were analyzed.The postoperative limb function was evaluated by the musculoskeletal tumor society(MSTS)score(30 points in total).Results:All patients were successfully completed tumor resection and reconstruction,bone reconstruction including modular prosthesis reconstruction,custom prosthesis reconstruction,3D printing prosthesis reconstruction.Soft tissue reconstruction including muscle flap transposition reconstruction,artificial patch reconstruction.There was no significant difference in operation time and blood loss among different groups(P>0.05).The extubation time of the shoulder group was shorter than that of the knee group(P>0.05).In terms of limb function score,the median MSTS score was(24.08±2.50).The MSTS score of knee joint group and shoulder joint group was significantly better than that of half pelvis group(P<0.05).In terms of postoperative complications,there was 1 case of joint dislocation.Conclusion:Artificial patch has high safety and practicability in tumor joint replacement.The use of artificial patch technology can better preserve the limb function of tumor joint patients after limb salvage surgery.Patch technology has well safety and clinical application value in the treatment of tumor joint patients with limb salvage,but there are certain application limitations for large-scale soft tissue defects.

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更新日期/Last Update: 1900-01-01