• 四川大學華西醫(yī)院骨科，四川成都 610041;

目的:探討術(shù)后早期康復(fù)護理干預(yù)對骨盆惡性腫瘤半骨盆切除、組合式半骨盆+全髖關(guān)節(jié)置換術(shù)后的患肢功能的影響。方法：從2004年9月至2007年5月采用半骨盆切除、組合式半骨盆假體+全髖關(guān)節(jié)置換術(shù)治療骨盆惡性骨腫瘤8例。其中軟骨肉瘤4例，平滑肌肉瘤2例，骨肉瘤1例，惡性骨巨細胞瘤1例。外科分期:ⅠB期6例，ⅡB期2例。術(shù)后根據(jù)腫瘤切除范圍、人工假體置換術(shù)后穩(wěn)定性和骨盆髖周動力肌修復(fù)后的平衡程度，決定術(shù)后患肢體位、患髖活動范圍、是否使用髖部支具；同時指導(dǎo)患者分階段、漸進地進行患肢足踝、膝、髖關(guān)節(jié)的主被動訓(xùn)練，以及下床負重時間和步態(tài)調(diào)整。結(jié)果：隨訪10～32個月，平均15月。1例術(shù)后16個月死于惡性腫瘤擴散轉(zhuǎn)移，7例存活。術(shù)后8個月患肢功能評定:優(yōu)2例，良6例。ISOLS評分:15～26分，平均19.47分。結(jié)論：①對骨盆惡性骨腫瘤患者積極進行術(shù)后早期康復(fù)護理干預(yù)能有效的防止人工髖關(guān)節(jié)早期脫位；②患肢各關(guān)節(jié)分階段有序的主動康復(fù)護理訓(xùn)練能提高骨盆和髖周肌肉肌力及其平衡度，對維持術(shù)后患者行走和步態(tài)的穩(wěn)定有重要意義。

引用本文： 廖燈彬,左建容,文守琴,張玉靜. 組合式半骨盆置換術(shù)后早期康復(fù)護理對患肢功能的影響?yīng)? 華西醫(yī)學, 2009, 24(1): 190-193. doi: 復(fù)制

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9. Windhager R，Karner J，Kutschera H.P.Limb Salvage in Periacetabular Sarcomas:Review of 21 Consecutive Cases[J].Clinical Orthopaedics and Related Research，1996，（331）:265276..
10. Enneking WF，Mindell ER.Observations on massive retrieved allografts[J].J Bone and Joint Surg，1991，73（8）:1123-1142..
11. Ozaki T，Hoffmann C，Hillmann A，et al.Implantation of hemipelvic prosthesis after resection of sarcoma[J].Clinical Orthopaedics & Related Research，2002，（396）:197-205..
12. Gradinger R，Rechl H，Hipp E.Pelvic osteosarcoma:Resection，reconstruction，local control，and survival statistics[J].Clinical Orthopaedics & Related Research，1991，270（1）:149-58..
  1. 1. Enneking WF，Dunham WK.Resection and reconstruction for primary neoplasms involving the innominate bone[J].J Bone and Joint SurgAmerican Volume，1978，60（6）:731-746..
  2. 2. 范靖宇，馬保安，周勇，等.骨盆腫瘤的手術(shù)治療[J].中華骨科雜志.2002，22:482-487..
  3. 3. Enneking WF，Dunham W，Cebhardt MC，et al.A System for the functional evaluation of reconstructive procedures aftersurgical treatment of tumors of the musculoskeletal system[J].Clinical Orthopaedics & Related Research，1993:241-246..
  4. 4. 郭衛(wèi).骨與軟組織腫瘤術(shù)后功能重建的評估標準[J].中華骨科雜志，2001，21（10）:635-636..
  5. 5. Steel，H H.Partial or complete resection of the hemipelvis.An alternative to hindquarter amputation for periacetabular chondrosarcoma of the pelvis[J].J Bone and Joint Surg，1978，60（6）:719-30. [6]郭衛(wèi)，徐萬鵬，李南，等.骨盆原發(fā)惡性腫瘤的手術(shù)治療[J].中華骨科雜志，2005，25（5）:276-279..
  6. 6. Satcher Jr RL，O’Donnell RJ，Johnston JO.Reconstruction of the pelvis after resection of tumors about the acetabulum[J].Clinical Orthopaedics & Related Research，2003，（409）:20917..
  7. 7. Nishida H，Tsuchiya H，Yamamoto N.Pelvic reconstruction using massive frozen autograft bearing tumor[J].Journal of Clinical Oncology，2004，22（14），828..
  8. 8. Ozaki T，Hillmann A，Bettin D，et al.High complication rates with pelvic allografts.Experience of 22 sarcoma resections[J].Acta Orthopaedica Scandinavica，1996，67（4）:333-8.
  9. 9. Windhager R，Karner J，Kutschera H.P.Limb Salvage in Periacetabular Sarcomas:Review of 21 Consecutive Cases[J].Clinical Orthopaedics and Related Research，1996，（331）:265276..
  10. 10. Enneking WF，Mindell ER.Observations on massive retrieved allografts[J].J Bone and Joint Surg，1991，73（8）:1123-1142..
  11. 11. Ozaki T，Hoffmann C，Hillmann A，et al.Implantation of hemipelvic prosthesis after resection of sarcoma[J].Clinical Orthopaedics & Related Research，2002，（396）:197-205..
  12. 12. Gradinger R，Rechl H，Hipp E.Pelvic osteosarcoma:Resection，reconstruction，local control，and survival statistics[J].Clinical Orthopaedics & Related Research，1991，270（1）:149-58..