肿瘤假体置换术与瘤段灭活再植术对四肢骨肉瘤患者肢体功能的影响

Effect of tumor prosthesis replacement and tumor segment inactivation replantation on limb function in patients with osteosarcoma of extremities

目的探讨肿瘤假体置换术与瘤段灭活再植术对四肢骨肉瘤患者肢体功能的影响。方法依据治疗方法的不同将96例四肢骨肉瘤患者分为观察组(n=51)和对照组(n=45),观察组患者给予肿瘤假体置换术治疗,对照组患者给予瘤段灭活再植术治疗。比较两组患者肢体功能、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8]及并发症发生情况。结果术前,两组患者Enneking评分比较,差异无统计学意义(P﹥0.05);术后,两组患者Enneking评分均高于本组术前,且观察组患者Enneking评分高于对照组,差异均有统计学意义(P﹤0.05)。术后,两组患者TNF-α、IL-6及IL-8水平均高于本组术前,但观察组患者TNF-α、IL-6及IL-8水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者均未发生假体松动。观察组患者患肢局部感染发生率低于对照组,差异有统计学意义(P﹤0.05),但两组患者延迟愈合和并发症总发生率比较,差异均无统计学意义(P﹥0.05)。结论肿瘤假体置换术可改善四肢骨肉瘤患者的肢体功能,减轻炎性反应,降低术后感染率。

Objective To investigate the effect of tumor prosthesis replacement and tumor segment inactivation replantation on limb function of patients with osteosarcoma of extremities. Method A total of 96 patients with limb osteosarcoma were divided into observation group(n=51, treated by tumor prosthesis replacement) and control group(n=45,treated by tumor inactivated replantation) according to different treatment methods. The limb function, serum inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interleukin-8(IL-8)] and complications were compared between the two groups. Result Before the operation, there was no significant difference for Enneking score(P>0.05).After the operation, the Enneking score in both groups were higher than those before operation, and the Enneking score of patients in the observation group was higher than that in the control group, the differences were statistically significant(P<0.05). After the operation, the TNF-α, IL-6 and IL-8 were higher than those before operation, but TNF-α, IL-6 and IL-8 in the observation group were lower than those in the control group, the differences were statistically significant(P<0.05). There was no prosthesis loosening. The incidence of local infection of affected limbs in the observation group was lower than that in the control group, with difference was statistically significant(P<0.05), but there were no statistically significant differences in the total incidence of complications and delayed healing between the two groups(P>0.05).Conclusion Tumor prosthesis replacement can improve the limb function of patients with osteosarcoma of limbs, reduce inflammatory reaction, and reduce postoperative infection rate.