【摘要】 回顾性分析2001-01/2007-12南京医科大学附属无锡二院骨科收治的髋臼周围骨盆恶性肿瘤患者12例,男5例,女7例,年龄51～72岁。病理诊断:软骨肉瘤3例,骨肉瘤2例,骨巨细胞瘤3例,腺癌2例,骨母细胞瘤2例。肿瘤部位按Enneking分区:Ⅰ区5例,Ⅱ区4例,Ⅲ区3例。置换前Harris评分平均(88.5±8.8)分。全部患者均采用鞍形人工关节置换且均顺利完成,无意外发生,置换时间2.5～3.5h;置换过程中出血量平均(1250±407)mL。12例患者均获得随访,随访时间5～36个月,平均18个月,1例置换后5个月死于肿瘤转移,全身衰竭。置换后发生切口感染1例,经置入抗生素骨水泥链珠治疗后切口愈合。置换后4个月肢体功能Harris评分:40～49分6例,50～59分3例,60～69分3例。置换后3个月拄双拐能下地行走12例,6个月能拄单拐行走3例;1例步态接近正常,多数步态较差,没有出现人工关节松动和脱位。提示鞍状关节置换后关节功能情况虽然大多不尽人意,但由于保留了患者的肢体,拄拐也能进行日常生活,对恶性肿瘤患者来说不失为一种较好的治疗方法。更多还原

【Abstract】 Twelve cases of pelvis sarcoma around acetabulum were selected from Department of Orthopaedics, Wuxi Second Hospital, Nanjing Medical University between January 2001 and December 2007 including 5 males and 7 females, aged 51-72 years. According to pathological diagnosis, there were 3 cases of sarcoenchondroma, 2 cases of osteosarcoma, 3 cases of giant cell tumor of bone, 2 cases of adenocarcinoma, and 2 cases of osteoblastoma. According to tumor position by Enneking dividatur sectors, there were 5 cases of Ⅰsector, 4 cases of Ⅱsector, and 3 cases of Ⅲ sector. The Harris score of pre-replacement was 88.5±8.8. All cases were treated by saddle prosthetic replacement successfully, and no accidents happened. The operation time was 2.5-3.5 hours; blood volume was (1 250±407) mL. Twelve cases were followed up for 18 months (range 5-36 months). One case died of tumor metastasis and body exhaustion 5 months postoperation. Infection of incision took place in 1 case, and cured by operation with antibiotic combined with bone cement chain pearls. The Harris scores 4 months post-replacement: 6 cases were between 40-49, 3 cases between 50-59, and 3 cases between 60-69. Twelve cases could walk with double orthosis 3 months postoperation, and 3 cases could walk with single orthosis 6 months postoperation; 1 case walked with near normal walking, but major walking was bad. No artificial joint loosening or dislocation occurred. Although the joint function of major cases treated by saddle prosthetic replacement was not fairly satisfactory, it is a better treating method for malignant tumor whose limbs can be reserved and live their daily life by orthosis.更多还原