可旋转稳定型假体与单纯铰链型假体治疗胫骨近端恶性骨肿瘤的疗效比较

Efficacy of rotatable stable prosthesis versus simple hinge prosthesis in the treatment of proximal malignant tibia tumors

目的探讨可旋转稳定型假体与单纯铰链型假体治疗胫骨近端恶性骨肿瘤的效果比较。方法选取2016年9月至2017年9月间重庆市开州区人民医院收治的100例胫骨近端恶性肿瘤患者作为研究对象。将采用植入可旋转稳定型膝关节假体治疗的50例患者纳入观察组,采用植入单纯铰链型假体治疗的50例患者纳入对照组。观察比较两组患者治疗后的关节功能、疼痛改善、术后并发症和生活质量指标。结果观察组膝关节功能优良率为94. 0%,高于对照组的80. 0%,差异有统计学意义(P <0. 05)。观察组膝关节伸直度高于对照组,差异有统计学意义(P <0. 05)。术后,观察组的视觉模拟评分(VAS)分值均显著低于对照组,差异有统计学意义(P <0. 05)。术后,观察组关节腔积血3例(6. 0%),对照组中腓总神经损伤4例(8. 0%),两组比较,差异无统计学意义(P> 0. 05)。术后6个月及12个月时,观察组生活质量评分中生理功能、生理职能和情感职能评分均高于对照组,差异均有统计学意义(均P <0. 05)。结论采用可旋转稳定型膝关节假体治疗胫骨近端恶性肿瘤患者可有效改善和提高患者的膝关节功能和生活质量,适于临床推广。

Objective To explore the efficacy of rotatable stable prosthesis versus simple hinge prosthesis in the treatment of proximal malignant tibia tumors. Methods One hundred patients with proximal malignant tibia tumors treated at Chongqing Kaizhou District People’s Hospital from September 2016 to September 2017 were selected. Patients using rotatable stable prosthesis were included in the observation group and patients using simple hinge prosthesis were included in the control group with 50 patients in each group. The joint function,pain improvement,postoperative tumor recurrence,complications and quality of life were compared between the two groups after the treatment. Results The excellent rate of knee joint function was 94. 0% in the observation group,which was significantly higher than 80. 0% of the control group( P < 0. 05). The straightening degree of knee was significantly higher in the observation group than in the control group( P < 0. 005). In postoperative follow-up,visual analogue scale( VAS) score was significantly lower in the observation group than in the control group( P < 0. 005). After the operation,hemarthrosis of the knee joint occurred in 3 patients( 6. 0%) in the observation group and peroneal nerve injury occurred in 4 patients( 8. 0%)( P > 0. 05). At 6 and 12 months,the physiological,physiological and emotional functions were significantly higher in the observation group than in the control group( P < 0. 001).Conclusion Rotatable stable knee prosthesis can improve the knee joint function and quality of life in patients with malignant proximal tibia tumors.