桡骨远端骨巨细胞瘤患者术后腕关节稳定性影像学参数与预后的关系

发布时间：2019-05-28 01:10

【摘要】：目的·分析桡骨远端Campanacci 3级骨巨细胞瘤患者的预后及其与术后腕关节稳定性相关影像学参数的关系。方法·收集2003年8月—2016年7月接受肿瘤广泛切除联合同侧自体腓骨重建术的15例桡骨远端Campanacci 3级骨巨细胞瘤患者资料,对临床及影像学资料进行回顾,分析患者预后及其与腕关节稳定性相关影像学参数的关系。结果·15例患者中14例完成随访,1例失访;平均随访时间为(62.3±43.3)个月。患者术前和术后国际骨与软组织肿瘤协会(MSTS)评分分别为21.6±2.0和23.1±2.2,功能有所改善,但差异无统计学意义(P=0.106)。与术前比较,术后疼痛评分(MSTS)和生活功能评分(MSTS)改善显著(4.1±0.5vs 2.9±0.7,P=0.000;3.7±0.7 vs 3.0±0.7,P=0.012)。相比对侧,术后患侧腕关节的关节活动度为(63.4±12.6)%,握力为(68.5±10.8)%。5例出现并发症(占35.7%),其中感染1例,骨不连3例,半脱位1例;无下肢功能障碍病例。术后MSTS评分为"良"和"优"患者的侧位片腓尺夹角分别为8.8?±5.6?和2.2?±2.4?(P=0.018);克氏针取出前后尺腓关节间隙的差异有统计学意义(P=0.003)。Pearson相关性分析结果显示骨愈合时间与取出克氏针后的腓骨尺偏角呈正相关(r=0.60,P=0.022)。结论·对于桡骨远端骨巨细胞瘤广泛切除联合同侧自体腓骨重建术患者,其预后可能与术后腕关节稳定性相关影像学参数有关。这对腓骨重建有一定的指导意义。
[Abstract]:Objective to analyze the prognosis of patients with Campanacci grade 3 giant cell tumor of radius and its relationship with postoperative wrist stability. Methods from August 2003 to July 2016, 15 patients with Campanacci grade 3 giant cell tumor of distal radius underwent extensive tumor resection combined with ipsilateral autologous fibula reconstruction, and the clinical and imaging data were reviewed. The prognosis of the patients and the relationship between the prognosis and the imaging parameters related to the stability of wrist joint were analyzed. Results of the 15 patients, 14 completed the follow-up and 1 lost the follow-up, and the average follow-up time was (62.3 卤43.3) months. The (MSTS) scores of the International Association of Bone and soft tissue Oncology before and after operation were 21.6 卤2.0 and 23.1 卤2.2, respectively. the function of the patients was improved, but the difference was not statistically significant (P 鈮，

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