CAJ | 학술논문

目的探讨骨盆肿瘤的发病特点、治疗和预后.方法回顾性分析2004年1月至2012年12月,我科收治的46例骨盆肿瘤及瘤样病变,男30例,女16例;年龄16~70岁,平均48岁;良性肿瘤20例,占44%.其中内生性软骨瘤6例,骨软骨瘤5例,单纯骨囊肿2例,骨巨细胞瘤2例,韧带样纤维瘤2例,骨巨细胞瘤并动脉瘤样骨囊肿1例,骨纤维结构不良1例,良性纤维组织细胞瘤1例.恶性肿瘤26例,占56%.其中骨肉瘤2例,软骨肉瘤6例,骨转移瘤18例.从临床、影像和病理分析骨盆肿瘤特点,39例行手术治疗,术后随访肿瘤复发情况及关节功能恢复情况.结果20例良性肿瘤完整随访,随访1~96个月,中位随访时间为54个月,均无复发,髋关节正常.26例恶性肿瘤随访1~9年,平均5年,6例软骨肉瘤未复发,2例骨肉瘤局部无复发,出现肺转移,均死于呼吸功能衰竭,18例恶性肿瘤骨转移患者中仍存活3例,19例手术后患者骨盆处症状明显改善,9例行骨盆重建术的患者术后复查均能做蹲起动作,步态基本恢复正常.7例行耻骨扩大切除术患者术后均未出现内脏器官的下坠.结论骨盆肿瘤中恶性肿瘤占较高比例,良性肿瘤手术后复发机会少;骨肉瘤及软骨肉瘤采取半骨盆截肢效果佳,肿瘤局部复发率低;骨盆恶性肿瘤切除重建术后患者肢体功能明显优于半盆截肢术,但须严格掌握手术适应证;对于恶性肿瘤单纯骨转移患者手术可明显减轻局部症状,改善患者的生存质量.04.co m编辑部(版权)
목적탐토골분종류적발병특점、치료화예후.방법회고성분석2004년1월지2012년12월,아과수치적46례골분종류급류양병변,남30례,녀16례;년령16~70세,평균48세;량성종류20례,점44%.기중내생성연골류6례,골연골류5례,단순골낭종2례,골거세포류2례,인대양섬유류2례,골거세포류병동맥류양골낭종1례,골섬유결구불량1례,량성섬유조직세포류1례.악성종류26례,점56%.기중골육류2례,연골육류6례,골전이류18례.종림상、영상화병리분석골분종류특점,39례행수술치료,술후수방종류복발정황급관절공능회복정황.결과20례량성종류완정수방,수방1~96개월,중위수방시간위54개월,균무복발,관관절정상.26례악성종류수방1~9년,평균5년,6례연골육류미복발,2례골육류국부무복발,출현폐전이,균사우호흡공능쇠갈,18례악성종류골전이환자중잉존활3례,19례수술후환자골분처증상명현개선,9례행골분중건술적환자술후복사균능주준기동작,보태기본회복정상.7례행치골확대절제술환자술후균미출현내장기관적하추.결론골분종류중악성종류점교고비례,량성종류수술후복발궤회소;골육류급연골육류채취반골분절지효과가,종류국부복발솔저;골분악성종류절제중건술후환자지체공능명현우우반분절지술,단수엄격장악수술괄응증;대우악성종류단순골전이환자수술가명현감경국부증상,개선환자적생존질량.04.co m편집부(판권)
@@@@Objective To investigate the pathogenesis, treatment and prognosis of pelvic tumors. Methods The data of 46 patients with pelvic tumors or tumor-like lesions who were adopted by our department from January 2004 to December 2012 were retrospectively analyzed. There were 30 males and 16 females, with a mean age of 48 years old ( range; 16-70 years ). There were 20 cases of benign tumors among them, including 6 cases of enchondromas, 5 cases of osteochondromas, 2 cases of simple bone cysts, 2 cases of giant cell tumors of bone, 2 cases of desmoplastic fibromas, 1 case of giant cell tumor and aneurysmal bone cyst, 1 case of osteofibrous dysplasia, and 1 case of benign fibrous histiocy toma. While there were 26 cases of malignant tumors, including 2 cases of osteosarcomas, 6 cases of chondrosarcomas, 18 cases of metastatic tumors of the bone. The characteristics of pelvic tumors were analyzed based on the clinical, imaging and pathological data. Surgeries were performed on 39 patients, and tumor recurrence and joint function recovery were followed up postoperaively. Results 20 patients with benign tumors were followed up completely for a median period of 54 months ( range;1-96 months ). No recurrence was found in them, and the hip function was normal. 26 patients with malignant tumors were followed up completely. No recurrence was found in 6 cases of chondrosarcomas. No local recurrence was found and lung metastases occurred in 2 patients with osteosarcomas, who died of respiratory failure. 3 of 18 patients with malignant metastatic tumors of bone were still living. The pelvic symptoms were obviously improved in 19 cases after the surgery. 9 patients could squat after pelvic reconstruction, and their gaits were almost back to normal. 7 patients with extended resection of the pubis did not have visceral organs dropping postoperatively. Conclusions Malignant pelvic tumors occupy a higher proportion than benign tumors. Recurrence of benign tumors occurs less frequently postoperatively. Hemipelvectomy is a good choice for patients with osteosarcomas or chondrosarcomas, with low local recurrence rates. The limb function after resection of malignant pelvic tumors and reconstruction is obviously superior to that after hemipelvectomy.However, the operation indications should be strictly grasped. For patients with simple malignant metastatic tumors of the bone, local symptoms can be obviously alleviated after surgery and patients’ quality of life can be improved.