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目的探讨四肢长骨骨转移癌外科治疗的疗效。方法四肢长骨骨转移癌49例,其中肱骨近端9例,肱骨干5例,股骨近端16例,股骨干10例,胫骨4例,腓骨3例,桡骨干2例。外科治疗:病灶刮除+骨水泥充填2例,病灶刮除、髓内钉固定+骨水泥充填26例,病灶刮除、钢板固定+骨水泥充填4例,扩大切除+特制人工假休12例,瘤段切除3例,截肢2例。结果随访时间4~52月,平均27.4个月,其中存活>6个月35例(71.4%),存活>12个月26例(53.1%)。所有患者疼痛均有不同程度缓解,33例下肢术后完全或单拐负重率为88%。术后局部复发6例(病灶刮除)。结论四肢长骨骨转移癌的外科治疗作为综合治疗的手段之一,可有效地缓解疼痛,改善肢体功能,提高生存质量。
Objective To investigate the curative effect of surgical treatment of long bone metastases of limbs. Methods 49 cases of long bone metastases of extremities, including 9 cases of proximal humerus, 5 cases of humeral shaft, proximal femur in 16 cases, 10 cases of femoral shaft, 4 cases of tibia, fibula in 3 cases, 2 cases of radial shaft. Surgical treatment: Lesion curettage + bone cement filling in 2 cases, curettage, intramedullary nailing + bone cement filling in 26 cases, curettage, plate fixation + bone cement filling in 4 cases, expand excision + special artificial leave in 12 cases , Tumor resection in 3 cases, amputation in 2 cases. Results The follow-up time ranged from 4 to 52 months, with an average of 27.4 months, of which 35 (71.4%) survived> 6 months and 26 (53.1%) survived> 12 months. All patients with pain relief to varying degrees, 33 cases of lower extremity after complete or single-crutch weight-bearing rate was 88%. Postoperative local recurrence in 6 cases (curettage). Conclusion Surgical treatment of long bone metastases of the extremities as one of the means of comprehensive treatment can effectively relieve pain, improve limb function and improve the quality of life.