CAJ | 학술논문

目的：探讨瘤段切除灭活再植术在儿童股骨恶性骨肿瘤治疗中的疗效。方法：回顾性研究2008年1月至2011年1月股骨恶性骨肿瘤行瘤段切除灭活再植术治疗的患者11例(男7例，女4例)，年龄(11.0±2.5)岁。其中骨肉瘤10例，尤文氏肉瘤1例，按照Enneking方法分期,所有患者均为IIb期。结果：本组病例术后都得到随访，随访时间24~65(42±20)个月，骨折端都达到骨性愈合。术中瘤段骨切除长度(17.5±3.2) cm，手术时间为(180±35) min，出血量(1200±250) mL。术后48 h内拔除引流管，引流量为(650±125) mL。1例(9.1%)出现局部皮肤坏死，通过伤口换药3周后伤口逐渐愈合。3处(27.3%)骨折断端骨愈合不良，予以骨折断端自体髂骨植骨后，骨折端愈合。1例(9.1%)发生肺转移，于术后35个月死亡。根据Enneking等肢体肌肉骨骼肿瘤外科治疗重建术后功能评估标准，功能评定优5例，良4例，中1例，差1例，优良率81.2%。结论：瘤段切除灭活再植术对于儿童股骨恶性骨肿瘤是一种可供选择的治疗方法。
목적：탐토류단절제멸활재식술재인동고골악성골종류치료중적료효。방법：회고성연구2008년1월지2011년1월고골악성골종류행류단절제멸활재식술치료적환자11례(남7례，녀4례)，년령(11.0±2.5)세。기중골육류10례，우문씨육류1례，안조Enneking방법분기,소유환자균위IIb기。결과：본조병례술후도득도수방，수방시간24~65(42±20)개월，골절단도체도골성유합。술중류단골절제장도(17.5±3.2) cm，수술시간위(180±35) min，출혈량(1200±250) mL。술후48 h내발제인류관，인류량위(650±125) mL。1례(9.1%)출현국부피부배사，통과상구환약3주후상구축점유합。3처(27.3%)골절단단골유합불량，여이골절단단자체가골식골후，골절단유합。1례(9.1%)발생폐전이，우술후35개월사망。근거Enneking등지체기육골격종류외과치료중건술후공능평고표준，공능평정우5례，량4례，중1례，차1례，우량솔81.2%。결론：류단절제멸활재식술대우인동고골악성골종류시일충가공선택적치료방법。
Objective:To evaluate the efficacy of femoral primary malignant bone tumors treated by limb salvage, with wide en bloc excision and reconstruction of the defect with recycled pasteurized autogratf. <br> Methods: From January 2008 to January 2011, 11 patients (7 males, 4 females), aged (11.0±2.5) years suffering from femoral primary malignant bone tumors were treated with en bloc excision and reconstruction of the defect with recycled pasteurized autograft. Ten patients were histopathologically diagnosed with high-grade osteosarcoma, and 1 with Ewing’s sarcoma.According to the Enneking staging system, all patients were in Stage IIb. <br> Results:All patients were followed-up for 24-65(42±20) months and all showed bony union at the last follow-up. hTe length of tumor bone resection was (17.5±3.2) cm, the operation time was (180±35) min, the intraoperative blood loss was (1200±250) mL, and drainage volume was (650±125) mL. Local skin necrosis occurred in 1 patient (9.1%), which was resolved by debridement. Nonunion occurred in 3 patients (27.3%), who were treated by secondary iliac crest cancellous bone gratfing.Pulmonary metastasis occurred in 1 patient (9.1%) who died 35 months post-operatively. According to the function assessment by the Enneking system, 5 patients had excellent results, 4 had good results, 1 fair and 1 poor results, with a satisfaction rate of 81.2%. <br> Conclusion:A pasteurized autograft can be an easily accessible and economical alternative for children’s malignant bone tumor of femurs.