半侧骨皮质切除灭活再植术对四肢低度恶性骨肿瘤的疗效分析

Effect Analysis of Hemilateral Osteocortical Resection and Inactivated Replantation in Low-degree Malignant Bone Tumors of the Limbs

目的探讨半侧骨皮质切除灭活再植术对四肢低度恶性骨肿瘤的疗效。方法选取四肢低度恶性骨肿瘤108例,依照随机数字表法划分为对照组(n=54)和研究组(n=54),对照组使用人工关节置换术,研究组使用半侧骨皮质切除灭活再植术。对比2组优良率、围术期变化、日常生活功能、肢体能力、血清因子[肿瘤坏死因子-α(TNF-α)、可溶性血管粘附分子(s VCAM-1)]、并发症发生率。结果研究组优良率[96.30%(52/54)]较对照组[72.22%(39/54)]高(P<0.05);与对照组比较,研究组手术时长、住院时长短,且术中出血量少(P<0.05);与对照组比较,术后6个月研究组日常生活功能、肢体能力分值高(P<0.05);与对照组比较,术后6个月研究组TNF-α、s VCAM-1水平低(P<0.05);研究组截肢、肌肉萎缩发生率[1.85%(1/54)、7.41%(4/54)]与对照组[5.56%(3/54)、14.81%(8/54)]比较,无显著变化(P>0.05),且研究组感染发生率[0.00%(0/54)]比对照组[16.67%(9/54)]低(P<0.05)。结论半侧骨皮质切除灭活再植应用于四肢低度恶性骨肿瘤中可以提高优良率,改善围术期变化,可下调血清因子,改善日常生活功能和肢体能力,并能降低术后感染发生风险。

Objective To discuss the efficacy of inactivated replantation in low-degree malignant bone tumors of the limbs.Methods 108 cases of low-degree malignant bone tumors in the limbs were selected.The control group(n=54)and the study group(n=54)were divided according to the randomized digital table.The control group used artificial joint replacement,and the study group used hemiosteocortical resection and inactivated regrafting.Comparison of excellent rate,perioperative changes,daily life function,limb ability,serum factors[tumor necrosis factor-(TNF-),soluble vascular adhesion molecule(s VCAM-1)],and complication incidence changes.Results The excellent rate was 96.30%(52/54)than 72.22%(39/54)(P<0.05);In comparison with the control group,The duration of surgery and the length of hospitalization in the study group,And less intraoperative bleeding(P<0.05);In comparison with the control group,High daily life function and limb ability scores in the study group at 6 months after surgery(P<0.05);In comparison with the control group,The levels of TNF-and s VCAM-1 were low in the study group at 6 months after surgery(P<0.05);The incidence of amputation and muscle atrophy in the study group was 1.85%(1/54),7.41%(4/54)and 5,5.56%(3/54)and 14.81%(8/54)(P>0.05),The incidence of infection of 0.00%(0/54)was lower than 16.67%(9/54)in the control group(P<0.05).Conclusion Reactivation and replantation in low malignant bone tumors can improve the excellent rate,improve perioperative changes,downregulate serum factors,improve daily life function and limb ability,and reduce the risk of postoperative infection.