异体骨复合带血管腓骨重建骨肿瘤切除后大段骨缺损的护理

Nursing of patients undergoing reconstruction of damaged massive bone using allogeneic bone and fibula with blood vessels

目的观察评价带血管腓骨复合异体骨重建长骨恶性肿瘤切除后骨缺损的临床护理方法的效果。方法对本科19例四肢长骨恶性骨肿瘤患者行保肢手术,肿瘤切除后骨缺损采用带血管自体腓骨复合大段异体骨进行重建,给予正确的围手术期护理和科学的患肢功能锻炼,总结围手术期护理经验。结果 19例患者术后恢复情况均良好,移植腓骨均成活,异体骨与宿主骨愈合良好,未发生感染及骨不连,随访11～46个月,术后MSTS功能评价上肢平均95.2%,下肢平均91.8%。结论 带血管自体腓骨复合异体骨可用于四肢长骨恶性肿瘤切除后骨缺损的重建,正确的围手术期护理和科学的患肢功能锻炼,对于提高手术疗效以及最大限度地改善患肢功能具有重大意义。

Objective To summarize the experience of nursing patients undergoing reconstruction of damaged massive bone using allogeneic bone and fibula with blood vessels. Methods 19 patients with malignant bone tumors in the limbs received limb salvage operations. The massive bones damaged from removal of tumors were reconstructed using allogeneie bone and fibula with blood vessels. The patients received right perioperative nursing and systematic functional training. The perioperative nursing experience was summarized. Results All the 19 patients were well rehabilitated, the grafted fibula all growing alive and the bone healing of allogeneic bone and host bones. There were no infections and the bones grew connected. The upper limbs and the lower ones were scored 95.2% and 91.8% by MSrPS function evaluation. Conclusions Allogeneic bone and fibula with blood vessels can be used for the reconstruction of damaged massive bones from resection of malignant bone tumors. The right perioperative nursing and scientific exercises for the function rehabilitation, are significant for improved operation tberapy and improving the function of diseased limbs.