髓内钉固定联合骨水泥填充治疗四肢骨干转移癌伴病理性骨折的临床研究

Clinical Study of Intramedullary Nailing Combined with Bone Cement Perfusion in the Treatment of Limbs Backbone Metastatic Carcinoma with Pathological Fracture

目的:研究髓内钉固定联合骨水泥填充治疗四肢骨干转移癌伴病理性骨折的临床疗效。方法:选取2009年1月到2014年1月我院收治的四肢骨干转移癌伴病理性骨折患者90例,所有患者均给予髓内钉固定联合骨水泥填充进行治疗。应用视觉模拟评分法(VAS)评定术前、术后患者的疼痛情况,应用Enneking评分来评价患者的肢体功能,应用Kanofsky评分法评价患者的生活质量。结果:所有患者均成功随访,随访时间为10-48个月,平均随访时间为(33.8±2.5)个月。所有患者围手术期均无感染或者其他并发症。术后VAS评分、Enneking评分以及Kanofsky评分均显著优于手术前,比较差异具有统计学意义(P<0.05);Enneking评分显示,32例优,34例良,22例中,2例差,优良率为73.3%。结论:髓内钉固定联合骨水泥填充治疗四肢骨干转移癌伴病理性骨折疗效确切,能显著改善肢体功能,减轻患者疼痛,提高患者的生活质量。

Objective： To study the clinical effect of intramedullary nailing combined with bone cement perfusion in the treatment of limbs backbone metastatic carcinoma with pathological fracture. Methods： Selected 90 patients with limbs backbone metastatic carci- noma with pathological fracture who were treated in our hospital from January 2009 to January 2014, they were all underwent with in- tramedullary nailing combined with bone cement perfusion operation. Compared the pain situation, limb function and the quality of life before and after operation respectively by visual analogue scale （VAS）, Enneking score, Kanofsky score method. Results： All patients were followed up successfully, the follow-up duration was 10-48 months, the average was （33.8＋ 2.5） months. All patients had no infec- tion or other complications in perioperativ~ period. VAS score, Enneking score and Kanofsky score before operation were significantly better than before operation, the differences were statistically significant （P〈0.05）; Euneking score result showed, there were 32 excellent patients, 34 benign patients, 22 medium patients, and 2 bad patients, the excellent and benign rate was 73.3%. Conclusion： Intramedullary nailing combined with bone cement perfusion has a exact effect in the treatment of limbs backbone metastatic carcinoma with pathological fracture, which can significantly improve limb function, relief pain, and improve the quality of life in patients.