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目的 探讨膝关节周围骨恶性肿瘤瘤段切除灭活再植术功能恢复相关的康复治疗。方法 本组79例 ,其中胫骨上端 2 1例 ,股骨远端 5 8例。常见肿瘤中骨肉瘤 5 7例 ,巨细胞瘤 6例 ,恶性纤维组织细胞瘤 6例 ,软骨肉瘤 5例。关节内瘤段切除灭活再植 75例 ,关节外瘤段切除灭活再植 4例。术后分 3个阶段采用不同的康复计划进行功能训练。结果 79例随访 1～ 7年 (平均 4.2年 ) ,5年生存率 42 % (33例 )。按Enneking法功能评定 ,关节内瘤段切除灭活再植 44例平均 2 0分 (14～ 2 5分 ) ,优良率达到 77% ;关节外瘤段切除灭活再植 4例平均 2 4分 (2 2～ 2 8分 ) ,效果全优。结论 瘤段切除灭活再植术是一种治疗膝关节周围骨恶性肿瘤较好的保肢方法 ,有计划的康复治疗有助于肢体功能的恢复。
Objective To investigate the rehabilitation related to the functional recovery of resection and inactivation of bone tumors around the knee joint. Methods There were 79 cases in this group, including 21 cases of upper humerus and 58 cases of distal femur. In common tumors, there are 57 cases of osteosarcoma, 6 cases of giant cell tumors, 6 cases of malignant fibrous histiocytoma, and 5 cases of chondrosarcoma. Intra-articular tumor resection and inactivation were replanted in 75 cases, and extra-articular tumor resection and inactivation were replanted in 4 cases. Different rehabilitation programs were used for functional training in three phases after surgery. Results 79 cases were followed up for 1 to 7 years (4.2 years on average). The 5-year survival rate was 42% (33 cases). According to the functional evaluation of Enneking method, 44 cases of intra-articular tumor resection and inactivation were replanted in 44 cases with an average of 20 points (14 to 25 points), and the excellent and good rate was 77%; 4 cases of extra-articular tumor resection and inactivation were replanted in an average of 24 points. (2 2 - 28 points), the effect is excellent. Conclusion Tumor segment resection and replantation is a good limb salvage method for the treatment of bone tumors around the knee. Planned rehabilitation can help restore the limb function.