抗感染骨肿瘤假体设计及其在保肢术中的应用

Resistance to infection of bone tumor prosthesis design and its application in limb-salvage surgery

目的:研究抗感染骨肿瘤假体的设计方案,并分析其在保肢术中的应用效果。方法:以2010年4月至2012年4月间行骨肿瘤切除、人工假体置换重建骨缺损的61例保肢术患者为研究对象,征得患者同意,对其中33例患者的假体行抗感染涂层设计,于假体表面涂布抗生素骨水泥,将其归入观察组;其余28例假体不做特殊处理,将其归入对照组。随访24个月,统计假体周围感染、肿瘤复发、远隔转移等并发症、肢体功能恢复情况及截肢率,进行对比。结果:随访期间,观察组无假体周围感染病例,对照组出现4例,差异具备统计学意义(P<0.05);观察组肿瘤复发2例,远隔转移1例,对照组肿瘤复发3例,远隔转移1例,差异无统计学意义(P>0.05);随访结束时,观察组MSTS93评分为(25.4±4.1)分,对照组为(18.9±3.1)分,差异具备统计学意义(P>0.05);观察组随访期间截肢2例,对照组截肢4例,差异不具备统计学意义(P>0.05)。结论:以抗生素骨水泥作为表面涂布剂,获得的骨肿瘤假体在控制假体周围感染方面优势显著,能有效提升患者预后,具备推广价值。

Objective:To study the resistance to infection of bone tumor prosthesis design,and analyzes its appli-cation effect in limb salvage surgery. Methods : Bone tumor resection, artificial prosthesis replacement reconstruction of bone defect 61 limb - salvage surgery patients were selected as the research object,the other 33 cases as observation group. Results : During follow - up, the observation group had no surrounding prosthesis infection in 4 cases, control group,the differences had statistical significance (P<0. 05) ;Observation group tumor recurrence in 2 cases, 1 case of far transfer,the control group (3 cases) ,tumor recurrence far transfer in 1 case (P >0. 05). At the end of follow 一 up,the observation group (25. 4 ±4. 1) points for MSTS93 score,control group is ( 18. 9 ± 3. 1) points (P <0.05). Conclusion:The bone cement as surface coating agents,with antibiotics for bone tumor prosthesis advantage significantly control infection around the prosthesis, effectively improve patient outcome.