股骨近端骨转移的手术治疗-文献回顾

Iordache Sergiu Andrei, Ş. Bogdan, Popa Mihnea Ioan Gabriel, Costache Mihai, Cursaru Adrian, Dumitrescu Dan
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引用次数: 0

摘要

肿瘤是全球第二大死亡原因。诊断可能性的增加和新治疗方法的发展导致癌症患者的预期寿命增加。股骨近端区域是骨转移的最佳部位,这些病变伴随着死亡率和发病率的增加。转移性骨病的治疗方法可以是手术或非手术。股骨近端骨转移和病理性骨折最常发生在粗隆间或粗隆下区域。在这一水平发生骨转移的患者通常需要用髓中心钉进行骨固定,但也可以使用钢板和螺钉或动态髋螺钉。位于股骨颈或股骨头的骨转移瘤可以通过半关节置换术(HA)或全髋关节置换术(THA)进行手术治疗。HA和THA已被证明是骨转移患者成功的手术。对于位于股骨头颈和粗隆区的多发性骨转移患者,但随着预期寿命的增加,使用内假体切除和重建是一种可行的解决方案。考虑到肿瘤病理的复杂性,继发性骨检测患者的治疗决定必须由包括肿瘤学家、骨科医生、病理学家、麻醉师和放射治疗师在内的多学科团队确定。手术治疗症状性骨转移引起疼痛和功能性阳痿,患者活动受限,无论手术类型和所选择的植入物如何,都可以提高生存率和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical management of bone metastasis located in the proximal femur-review of literature
Abstract Neoplasms are the second leading cause of death worldwide. The increase in diagnostic possibilities and development of new treatments has led to an increase in life expectancy among cancer patients. The proximal region of the femur is a favorite site for bone metastases, these lesions being accompanied by increased mortality and morbidity. The methods of treatment for metastatic bone disease can be surgical or non-surgical. Bone metastases and pathological bone fractures in the proximal femur are most commonly located in the intertrochanteric or subtrochanteric region. Patients with bone metastases at this level most often require osteosynthesis with a centromedullary nail, but also plates and screws or dynamic hip screw can be used. Bone metastases located in the femoral neck or femoral head can be treated surgically by hemiarthroplasty (HA) or total hip arthroplasty (THA). Both HA and THA have been shown to be successful surgeries in patients with bone metastases. In patients with multiple bone metastases located in the head or neck of the femur and trochanteric region, but with increased life expectancy, resection and reconstruction using endoprostheses is a viable solution. Given the complexity of oncological pathologies, the therapeutic decision in the case of a patient with secondary bone determinations must be established by a multidisciplinary team comprising the oncologist, orthopedic surgeon, pathologist, anesthetist, and radiotherapist. Surgical treatment of symptomatic bone metastases that cause pain and functional impotence with limited patient mobility increases survival and quality of life regardless of the type of surgery and the implant chosen.
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