特制组合式人工半骨盆治疗骨盆恶性骨肿瘤

Implantation specially designed combinational hemipelvic prosthesis after resection of malignant pelvic tumors

目的 探讨半骨盆切除特制组合式人工半骨盆假体 (包括髋关节 )置换术治疗骨盆恶性骨肿瘤的临床效果。方法 从 1 991年 4月至 2 0 0 1年 4月采用半骨盆切除特制组合式人工半骨盆假体 (包括髋关节 )置换术治疗骨盆恶性骨肿瘤 9例。其中软骨肉瘤 3例 ,尤文肉瘤 2例 ,成骨肉瘤 2例 ,恶性纤维组织细胞瘤 1例 ,多发性骨髓瘤 1例。外科分期ⅡB 期 8例 ,ⅠB 期 1例。半骨盆假体通过三维测量设计为患者特制。结果 随访 1 2～ 92个月 ,平均 43 3个月。 4例死于恶性肿瘤扩散 ,5例存活。骨盆肿瘤切除术后功能评定优 2例 ,良 1例 ,可 1例。 3例无并发症 ,6例发生并发症。 9例患者共行 2 4次手术 ,包括首次手术平均 2 67次 /人。结论 半骨盆切除特制假体置换术后功能评定结果尚满意 ,但并发症较多 ,适用于低度恶性骨盆肿瘤的治疗。

Objective To investigate threapy outcomes of implantation specially designed combinational hemipelvic prosthesis(including total hip replacement)after resectinn of malignant pelvic tumors.Methods From April 1991 to April 2001.9 patients with malignant plevic tumors were treated by implantation specially designed combinational hemipelvic prosthesis (including total hip replacement)after resectinn of malignant pelvic tumors. Among them,there were 3 cases of chondrosarcoma,2 cases of Ewing’s sarcoma,2 cases of osteosarcoma,1 case of malignant fibrous histiocytoma,1 case of multiple myeloma.In this series,8 patients classified as stage Ⅱ B,1 patients classifued as stage Ⅰ B.Results The followup ranged from 12～92months(median 43 months).Four pantients died of tumor.Five patients were still alive at the most recent followup.The results of postoperative fumctional score were 2 execllent,1 good,1 fair.There were 6 patients with complications,3 patients without complications.9 patients had 24 (2.67 times per patient)surgeries,including primary surgeries.Conclusion After hemipelvic resection inclulding the proximal femour,implantation of a specially designed combinational hemipelvic prosthesis(including total hip replacement)had a satisfically functional result,but leaded to a high rate of complication.In our opinion,the surgery may be indicate as curative treatment for primary tumors with a low risk of metastasis and thus an associated long life expectancy.