目的:探讨术后早期康复护理干预对骨盆恶性肿瘤半骨盆切除、组合式半骨盆+全髋关节置换术后的患肢功能的影响。方法：从2004年9月至2007年5月采用半骨盆切除、组合式半骨盆假体+全髋关节置换术治疗骨盆恶性骨肿瘤8例。其中软骨肉瘤4例，平滑肌肉瘤2例，骨肉瘤1例，恶性骨巨细胞瘤1例。外科分期:ⅠB期6例，ⅡB期2例。术后根据肿瘤切除范围、人工假体置换术后稳定性和骨盆髋周动力肌修复后的平衡程度，决定术后患肢体位、患髋活动范围、是否使用髋部支具；同时指导患者分阶段、渐进地进行患肢足踝、膝、髋关节的主被动训练，以及下床负重时间和步态调整。结果：随访10～32个月，平均15月。1例术后16个月死于恶性肿瘤扩散转移，7例存活。术后8个月患肢功能评定:优2例，良6例。ISOLS评分:15～26分，平均19.47分。结论：①对骨盆恶性骨肿瘤患者积极进行术后早期康复护理干预能有效的防止人工髋关节早期脱位；②患肢各关节分阶段有序的主动康复护理训练能提高骨盆和髋周肌肉肌力及其平衡度，对维持术后患者行走和步态的稳定有重要意义。
Citation：
LIAO Dengbin,ZUO Jianrong,WEN Shouqin,et al. Effect of Affected Limb’s Function Caused by Postoperative Early Rehabilitative Nursing after Implanting Modular Hemipelvic Prosthesis. West China Medical Journal, 2009, 24(1): 190-193. doi:
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- 1. Enneking WF，Dunham WK.Resection and reconstruction for primary neoplasms involving the innominate bone[J].J Bone and Joint SurgAmerican Volume，1978，60（6）:731-746..
- 2. 范靖宇，马保安，周勇，等.骨盆肿瘤的手术治疗[J].中华骨科杂志.2002，22:482-487..
- 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. 郭卫.骨与软组织肿瘤术后功能重建的评估标准[J].中华骨科杂志，2001，21（10）:635-636..
- 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]郭卫，徐万鹏，李南，等.骨盆原发恶性肿瘤的手术治疗[J].中华骨科杂志，2005，25（5）:276-279..
- 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）:20917..
- 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. 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. 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）:265276..
- 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..
