反式肩关节置换治疗肱骨上段骨肿瘤疗效观察

Trans-Shoulder Replacement Treatment of Upper Humerus Bone Tumor

目的探讨肱骨上段骨肿瘤经反式肩关节置换治疗的主要方法,并观察其近期疗效.方法 8例肱骨上段骨肿瘤患者均采用反式肩关节置换治疗,术后平均随访2.5 a(12~60个月),并对其生存情况、肩关节功能恢复情况以及并发症等近期疗效予以评价.结果术后有1例患者因肺转移死亡,死亡率为12.5%,其余7例患者均治愈出院;术后1 a生存率为91.67%;术后患者的疼痛评分明显降低,心理接受程度评分、功能活动度、提重物、灵活性等评分均明显上升,总分高于术前,前后评分差异具有统计学意义(P<0.05);术后患者关节的外旋、前屈和外展等活动度均明显优于术前,前后差异均具有统计学意义(P<0.05);本组患者共有2例出现并发症,发生率为25%.结论采用反式肩关节置换术治疗肱骨上段骨肿瘤临床效果显著,近期生存率较高,肩关节活动功能恢复良好,但易引起多种并发症,其远期疗效还有待深入研究和观察.

Objective To investigate the main methods of trans-articular replacement of upper humerus bone tumors and to observe its short-term therapeutic effect.Method Eight cases with upper humerus bone tumors were studied.All patients were treated with trans-shoulder replacement.The patients were followed up for an average of 2.5 years(range 12 to 60 months),its survival,recovery of shoulder joint function and complications and other short-term efficacy were evaluated.Results One patient died of pulmonary metastasis after operation.The mortality rate was 12.5%.The remaining 7 patients were cured and discharged.The survival rate after surgery was 91.67%.After the operation,the pain scores of the patients decreased significantly.The scores of psychological acceptability,functional activity,weight lifting,flexibility and so on were significantly increased,the total score was higher than before surgery,there was significant difference(P<0.05).After the operation,the activities of external rotation,flexion and abduction of the patients were significantly better than those before the operation.There were significant differences between the two groups(P<0.05).A total of 2 patients in this group of complications,the incidence was 25%.Conclusion Trans-articular arthroplasty for the treatment of upper humerus bone tumors has significant clinical effect.The recent survival rate and functional recovery of shoulder joint are good,but it is easy to cause many complications.The long-term curative effect needs further study and observation.