中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
7期
497-500
,共4页
金韬%刘巍峰%李远%邓志平%牛晓辉
金韜%劉巍峰%李遠%鄧誌平%牛曉輝
금도%류외봉%리원%산지평%우효휘
骨肿瘤%髂骨%骶髂关节%修复外科手术
骨腫瘤%髂骨%骶髂關節%脩複外科手術
골종류%가골%저가관절%수복외과수술
Bone neoplasms%Ilium%Sacroiliac joint%Reconstructive surgical procedures
目的：探讨单纯髂骨切除术治疗髂骨原发恶性肿瘤的手术方法，分析其肿瘤学结果及骶髂关节连续性对患者肢体功能的意义。方法回顾分析1983年6月至2011年6月，诊断为髂骨原发恶性肿瘤并于我院骨肿瘤科行单纯髂骨切除术且资料完整的患者25例。分析该术式对髂骨恶性肿瘤的治疗效果及手术后骶髂关节连续性对患者肢体功能的影响。结果25例均于我院进行手术治疗，男19例，女6例。病例分布为软骨肉瘤13例，骨肉瘤6例，尤文肉瘤2例，梭形细胞肉瘤2例，未分化多形性肉瘤2例。随访14.2～127.9个月，平均41个月。截止随访期末，18例未发现肿瘤复发或转移。1例骨肉瘤患者于术后9个月出现肺转移，行胸腔镜肺部病灶切除，1例尤文肉瘤患者术后58个月出现肺部转移，行化疗，1例软骨肉瘤患者术后23个月出现局部复发，再次手术切除，此3例目前均存活。4例死亡，1例骨肉瘤患者术后10个月出现肺部转移，术后18个月死亡；1例软骨肉瘤患者术后12个月出现肺部转移，术后15个月死亡；1例术后29个月发现局部复发及肺部转移，术后39个月死亡；1例骨肉瘤患者术后26个月因肝功能衰竭死亡。15例可行MSTS评分系统进行评分，平均为27.5(24～30)分。其中10例骶髂关节连续性存在，MSTS评分平均为28.8分，5例骶髂关节连续性破坏，MSTS评分为25.0分。结论单纯髂骨切除术是治疗髂骨原发恶性肿瘤的有效术式，骶髂关节失去连续性对行走功能有一定影响。其功能可满足日常生活需要。
目的：探討單純髂骨切除術治療髂骨原髮噁性腫瘤的手術方法，分析其腫瘤學結果及骶髂關節連續性對患者肢體功能的意義。方法迴顧分析1983年6月至2011年6月，診斷為髂骨原髮噁性腫瘤併于我院骨腫瘤科行單純髂骨切除術且資料完整的患者25例。分析該術式對髂骨噁性腫瘤的治療效果及手術後骶髂關節連續性對患者肢體功能的影響。結果25例均于我院進行手術治療，男19例，女6例。病例分佈為軟骨肉瘤13例，骨肉瘤6例，尤文肉瘤2例，梭形細胞肉瘤2例，未分化多形性肉瘤2例。隨訪14.2～127.9箇月，平均41箇月。截止隨訪期末，18例未髮現腫瘤複髮或轉移。1例骨肉瘤患者于術後9箇月齣現肺轉移，行胸腔鏡肺部病竈切除，1例尤文肉瘤患者術後58箇月齣現肺部轉移，行化療，1例軟骨肉瘤患者術後23箇月齣現跼部複髮，再次手術切除，此3例目前均存活。4例死亡，1例骨肉瘤患者術後10箇月齣現肺部轉移，術後18箇月死亡；1例軟骨肉瘤患者術後12箇月齣現肺部轉移，術後15箇月死亡；1例術後29箇月髮現跼部複髮及肺部轉移，術後39箇月死亡；1例骨肉瘤患者術後26箇月因肝功能衰竭死亡。15例可行MSTS評分繫統進行評分，平均為27.5(24～30)分。其中10例骶髂關節連續性存在，MSTS評分平均為28.8分，5例骶髂關節連續性破壞，MSTS評分為25.0分。結論單純髂骨切除術是治療髂骨原髮噁性腫瘤的有效術式，骶髂關節失去連續性對行走功能有一定影響。其功能可滿足日常生活需要。
목적：탐토단순가골절제술치료가골원발악성종류적수술방법，분석기종류학결과급저가관절련속성대환자지체공능적의의。방법회고분석1983년6월지2011년6월，진단위가골원발악성종류병우아원골종류과행단순가골절제술차자료완정적환자25례。분석해술식대가골악성종류적치료효과급수술후저가관절련속성대환자지체공능적영향。결과25례균우아원진행수술치료，남19례，녀6례。병례분포위연골육류13례，골육류6례，우문육류2례，사형세포육류2례，미분화다형성육류2례。수방14.2～127.9개월，평균41개월。절지수방기말，18례미발현종류복발혹전이。1례골육류환자우술후9개월출현폐전이，행흉강경폐부병조절제，1례우문육류환자술후58개월출현폐부전이，행화료，1례연골육류환자술후23개월출현국부복발，재차수술절제，차3례목전균존활。4례사망，1례골육류환자술후10개월출현폐부전이，술후18개월사망；1례연골육류환자술후12개월출현폐부전이，술후15개월사망；1례술후29개월발현국부복발급폐부전이，술후39개월사망；1례골육류환자술후26개월인간공능쇠갈사망。15례가행MSTS평분계통진행평분，평균위27.5(24～30)분。기중10례저가관절련속성존재，MSTS평분평균위28.8분，5례저가관절련속성파배，MSTS평분위25.0분。결론단순가골절제술시치료가골원발악성종류적유효술식，저가관절실거련속성대행주공능유일정영향。기공능가만족일상생활수요。
Objective To investigate the surgical method of simple resection of the ilium for primary malignant iliac bone tumors and to analyze the oncological outcomes and the effects of continuity of the sacroiliac joint on the limb function of the patients.Methods The complete data of 25 patients with primary malignant iliac bone tumors who underwent simple resection of the ilium from June 1983 to June 2011 were retrospectively analyzed. The therapeutic effects of this surgical method on malignant iliac bone tumors and the effects of the postoperative continuity of the sacroiliac joint on the limb function of the patients were analyzed.Results All 25 patients underwent the surgical treatment in our hospital, including 19 males and 6 females. There were 13 cases of chondrosarcoma, 6 cases of osteosarcoma, 2 cases of Ewing's sarcoma, 2 cases of spindle cell sarcoma and 2 cases of undifferentiated pleomorphic sarcoma. The mean follow-up period was 41 months ( range: 14.2-127.9 months ). At the end of the follow-up, no recurrence or metastasis was found in 18 patients. One patient with osteosarcoma had lung metastases at 9 months after the operation, and then underwent thoracoscopic resection of pulmonary lesions. One patient with Ewing’s sarcoma had lung metastases at 58 months after the operation, and then received chemotherapy. One patient with osteosarcoma had local recurrence at 23 months after the operation, and then underwent surgical resection once again. So far all the 3 patients mentioned above survived. There were 4 cases of death. One patient with osteosarcoma had lung metastasis at 10 months after the operation, who died at 18 months after the operation. One patient with chondrosarcoma had lung metastasis at 12 months after the operation, who died at 15 months after the operation. One patient with chondrosarcoma had lung metastasis and local recurrence at 29 months after the operation, who died at 39 months after the operation. One patient with osteosarcoma died at 26 months after the operation due to liver failure. Fifteen cases could be analyzed according to the Musculoskeletal Tumor Society ( MSTS ) score system, with an average score of 27.5 points ( range: 24-30 points ). The average MSTS score in the 10 patients with the continuity of the sacroiliac joint was 28.8 points, while it was 25.0 points in the 5 patients with the continuity of the sacroiliac joint interrupted.Conclusions The simple resection of the ilium is an effective surgical method for primary malignant iliac bone tumors. The walking function of the patients will be affected due to the interrupted continuity of the sacroiliac joint. But the everyday life needs can be met.
