摘要
目的探讨原位微波灭活术治疗骨盆原发恶性肿瘤及转移瘤的疗效。方法2000年2月至2009年4月对18例骨盆原发恶性肿瘤及转移瘤患者采用原位微波灭活及肿瘤全部或部分切除，男11例，女7例；年龄16-72岁，平均45岁。原发恶性骨肿瘤12例，转移瘤6例。肿瘤累及Ⅰ区6例、Ⅱ区10例、Ⅲ区2例。根据肿瘤所在区域采用传统髂腹股沟切口或髂腹股沟“T”形切口进行显露，以铜网保护周围软组织，用2450MHz微波将肿瘤局部加热至50℃，持续20min，全部或部分剥离坏死肿瘤组织，保留骨盆环的解剖连续性。结果手术时间60-180min，平均110min；术中失血量400～800ml，平均480ml。无严重的术中及术后并发症。随访0．5-7年，平均3．5年。1例软骨肉瘤患者术后8个月复发，随访6个月带瘤生存。1例恶性纤维组织细胞瘤患者术后24个月出现肺、脑和全身多发转移死亡。1例骨肉瘤患者术后18个月出现肺转移死亡。6例骨盆转移瘤患者中5例分别于术后6-19个月出现其他部位转移而死亡。术后3个月18例患者患侧髋关节屈曲80°-130°，后伸0°-10°，外展25°-35°，内收18°-23°。结论原位微波灭活术具有操作简便、疗效可靠、创伤小的特点，可用于或辅助用于骨盆恶性骨肿瘤的治疗，能保持骨盆环的完整性。
Objective To investigate the clinical outcomes of microwave heliotherapy in situ on the primary or metastatic malignant tumors of the pelvis. Methods From February 2000 to April 2009, 18 patients with primary or metastatic malignant tumors of the pelvis were treated with microwave heliotherapy in situ, and followed a total or partial tumor resection. There were 11 males and 7 females with an average age of 45 years （range, 16-72）. Twelve cases were diagnosed as primary malignant tumor and 6 as metastases. Locations of tumors involved： the Ⅰ region 6 cases, the Ⅱ region 10 cases, and the Ⅲ region 2 cases. The exposures of all tumors were via a ＂T＂ type or ilioinguinal approach. The lesions were heated at 50 ℃ for 20 min by 2450 MHz microwave ,with surrounding soft tissue protected by copper, mesh. The necrotic tumor tissues were total or partial excised after treatment, with preservation of the anatomical continuity of the pelvic ring. Results The duration of surgery was 60-180 rain （110 min on average）. The blood loss was 400-800 ml （480 ml on average）. All patients were followed-up for 0.5-7 years （3.5 years on average）. Tumor local recurred in 1 case with chondrosarcoma, and was survival in tumor-bearing after 6 months follow up. One case with malignant fibrous histiocytoma died due to brain, pulmonary, and all body metastases. One case with osteosarcoma died due to pulmonary metastases. Five cases with the metastases died due to non-pelvis metastases. Functions of hip joint in 18 patients were as follows： flexion 80°-130°, extension 0°-10°, abduction 25o-35°, and adduction 18°-23°. Conclusion The clinical result demonstrated that the advantages of microwave heliotherapy in situ were quick increase of temperature, sensitive responses, easy control of temperature, and effective inactivation of tumor cells in the malignant bone tumors of pelvis.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2011年第6期629-634,共6页
Chinese Journal of Orthopaedics
关键词
骨盆
骨肿瘤
微波
Pelvis
Bone neoplasms
Microwaves
