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[目的]探讨病灶清除后骨水泥填充加锁定钢板内固定治疗长骨转移癌伴病理性骨折的临床疗效。[方法]2005年2月～2008年2月,对本院收治15例骨转移癌伴长骨病理性骨折患者,其中肱骨3例,尺骨2例,桡骨1例,股骨5例,胫骨4例,采用骨水泥填充+锁定钢板内固定进行手术治疗。[结果]所有患者均有随访,随访时间24～46个月,平均35.6个月。术后14例(93.3%)疼痛症状明显减轻,疼痛评分改善率[(手术前评分-手术后评分)/手术前评分]为75%;术后2周Enneking肢体功能评分为优者13例(86.7%),改善率[(手术后评分-手术前评分)/手术后评分]为72%。手术前、后患者生活质量评分有显著统计学意义(P<0.05)。本组病例术后6个月生存率为60%,术后2年生存率为26.7%。[结论]对于长骨转移癌伴病理性骨折患者,尤其是近关节部位,骨水泥填充+锁定钢板内固定是一种安全、有效的手术方式,该手术可明显减轻患处疼痛、改善肢体功能、提高患者的生活质量,同时还能方便患者接受护理和进一步综合治疗。手术中骨水泥灌注确实、选择合适锁定钢板,是提高临床效果的有效办法。
[Objective] To investigate the clinical effect of bone cement filling and locked plate internal fixation for the treatment of long bone metastases with pathological fractures. [Methods] From February 2005 to February 2008, 15 patients with long bone fracture complicated with bone metastases were treated in our hospital. There were 3 cases of humerus, 2 cases of ulna, 1 case of radius, 5 cases of femur, 4 cases of tibia, The use of bone cement filling + locking plate fixation for surgical treatment. [Results] All patients were followed up for 24 to 46 months with an average of 35.6 months. Postoperative pain relief was significantly relieved in 14 cases (93.3%). The rate of pain score improvement (preoperative score - postoperative score / preoperative score) was 75%. Enneking limb functional score at 2 weeks postoperatively was excellent in 13 cases 86.7%), improvement rate [(postoperative score - preoperative score) / postoperative score] was 72%. The quality of life of patients before and after surgery had significant statistical significance (P <0.05). This group of patients 6 months after the survival rate was 60%, 2-year survival rate was 26.7%. [Conclusion] For patients with long bone metastases and pathological fractures, especially near the joint site, internal fixation with cement-filled and locked plate is a safe and effective surgical method. This operation can significantly reduce the pain in the affected area and improve limb function, The patient’s quality of life, while also facilitating patient care and further treatment. The bone cement infusion surgery indeed, select the appropriate locking plate, is an effective way to improve clinical outcomes.