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目的:探讨胫骨上端骨肉瘤保肢手术中使用人工关节重建的疗效和并发症。方法:回顾性分析2000年6月～2010年6月对21例胫骨上段骨肉瘤患者行根治性切除人工关节重建手术的临床资料,其中男性13例,女性8例,年龄21-62岁,平均34.1岁。依据Enneking分期:ⅡA期12例、ⅡB期9例。均采用广泛性边缘切除手术治疗。所有患者均接受术前、术后化疗。结果:1例患者发生术后胫前肌群坏死。所有患者均随访6-72个月,平均45.1个月。ⅡA期12例患者中,1例因肺转移死亡(占8.3%),局部复发1例,行股骨下段截肢,10例无病生存;ⅡB期9例,4例死亡,5例存活;Enneking分期明显影响预后。结论:胫骨上段人工关节重建对胫骨上段骨肉瘤的保肢治疗具有良好的疗效。
Objective: To investigate the efficacy and complications of artificial joint reconstruction in limb salvage surgery of upper tibial osteosarcoma. Methods: The clinical data of 21 patients with upper tibial osteosarcoma undergoing radical resection of artificial joint reconstruction from June 2000 to June 2010 were retrospectively analyzed. There were 13 males and 8 females, aged 21-62 years, with an average of 34.1 years old. According to Enneking staging: Ⅱ A period in 12 cases, Ⅱ B period in 9 cases. The use of extensive marginal resection surgery. All patients underwent preoperative and postoperative chemotherapy. Results: One patient had postoperative anterior tibial muscle necrosis. All patients were followed up for 6-72 months, an average of 45.1 months. Of the 12 patients with stage IIA, 1 died of pulmonary metastasis (8.3%), 1 case of local recurrence, 10 cases of amputation of the femur and 10 cases of disease-free survival; 9 cases of stage IIB, 4 died and 5 cases survived; Enneking staging Significantly affect the prognosis. Conclusion: Artificial joint reconstruction of the upper tibia has good curative effect on limb salvage treatment of upper tibial osteosarcoma.