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目的观察定制人工肱骨头置换治疗肱骨近端肿瘤的疗效。方法回顾性分析2007年10月至2011年2月河南省人民医院收治的肱骨近端肿瘤的患者16例,其中骨肉瘤6例,软骨肉瘤3例,骨巨细胞瘤5例,转移癌2例,记录术后患者3年生存率,假体并发症及关节功能(采用Neer评分)。所有计数资料采用χ2检验,计量资料以(xˉ±s)表示,采用t检验,P<0.05为差异有统计学意义。结果随访12~60个月,平均46个月。术后局部复发2例,远处转移3例,3年生存率62.5%。术后出现关节不稳1例;术前Neer评分为(43.2±6.2)分,术后为(74.1±4.5)分,差异有统计学意义(P<0.05)。结论定制人工肱骨头置换治疗肱骨近端肿瘤疗效可靠,肩袖的重建及术后系统的康复训练是关节功能恢复及降低并发症的关键。
Objective To observe the curative effect of custom artificial humeral head replacement on the proximal humerus tumor. Methods A retrospective analysis of 16 patients with proximal humeral tumors admitted from Henan Provincial People’s Hospital from October 2007 to February 2011 included 6 cases of osteosarcoma, 3 cases of chondrosarcoma, 5 cases of giant cell tumor of bone, 2 cases of metastatic carcinoma The postoperative 3-year survival rate, prosthetic complications and joint function (Neer score) were recorded. All count data using χ2 test, measurement data to (x ˉ ± s), using t test, P <0.05 was considered statistically significant. The results were followed up for 12 to 60 months, an average of 46 months. Local recurrence in 2 cases, distant metastasis in 3 cases, 3-year survival rate of 62.5%. Postoperative arthrosis was found in 1 case. The preoperative Neer score was (43.2 ± 6.2) points and postoperatively (74.1 ± 4.5) points, the difference was statistically significant (P <0.05). Conclusion The customized artificial humeral head replacement for the treatment of proximal humeral tumors has reliable curative effect. The reconstruction of rotator cuff and postoperative rehabilitation training are the keys to joint function recovery and reduce complications.