Time of survival and quality of life of the patients operatively treated due to pathological fractures due to bone metastases.
Time of survival and quality of life of the patients operatively treated due to pathological fractures due to bone metastases.
复制标题
骨转移病理性骨折接受手术治疗的患者的生存时间和生活质量。
DOI：
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发表时间：
2003
影响因子：
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通讯作者：
P. Sosin
中科院分区：
文献类型：
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作者：
J. Dutka;P. Sosin
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背景资料。
研究的目的
1)评价骨转移瘤手术后患者的生活质量；2)评价骨转移瘤术后患者的生存率；3)提出作者的骨转移瘤手术疗效评价临床评分系统；4)骨转移瘤手术治疗后一般并发症发生率的分析。材料和方法。对本院13年来收治的62例骨转移瘤患者的临床资料进行了回顾分析。患者平均年龄63.6岁。共有41名女性(平均年龄62，8岁)和21名男性(平均年龄：64，3岁)。49例(79%)能明确肿瘤的原发部位：乳腺癌22例，卵巢癌6例，肺癌5例，前列腺癌5例，肾癌6例，胃癌1例，阴道癌1例，肝细胞癌1例，黑色素瘤1例，浆细胞瘤1例。骨转移部位：股骨49例，肱骨10例，胫骨3例。接受手术治疗后，患者均尽快治愈，有时在急诊时治愈。胫骨转移瘤2例，股骨截肢。其余病例局部切除转移瘤内固定加骨水泥47例，单纯内固定7例，髋关节置换术8例。结果。我们有4，8%的结果不佳，因为有3名患者死亡。手术后平均随访时间为6个月。82.3%的患者有非常好或很好的效果--没有疼痛，功能良好，在日常活动中独立。生存时间5~36个月，平均17.5个月。结论。骨转移瘤致病理性骨折的手术治疗在缓解疼痛、改善患者活动能力和日常生活活动能力等方面效果良好。尽管一般并发症发生率较高，但研究组因骨转移所致的病理性骨折手术后的平均生存时间证明其应用是合理的。
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Background.
AIMS OF THE STUDY
1) evaluation of the quality of life of the patients after surgical treatment of bone metastases, 2) evaluation of survival rate of the patients after surgical treatment of bone metastases, 3) presentation of the authors' clinical score system for evaluation of the treatment results of bone metastases, 4) analysis of general complications rate after surgical treatment of bone metastases. Material and methods. Retrospective evaluation of 62 patients with bone metastases treated operatively in our Ward during last 13 years was made. Mean age of patients was 63,6 years. There were 41 women (mean age; 62,8 years) and 21 men (mean age: 64,3). In 49 cases (79%) we were able to diagnose primary localization of the tumour: breast carcinoma - 22, ovary cancer - 6, lung cancer - 5, prostate cancer - 5, kidney cancer - 6, gastric cancer - 1, vaginal cancer - 1, hepatocellular cancer - 1, melanoma - 1 and plasmocytoma - 1. We could not reveal primary focus of the tumour in 13 cases (21%). Localizations of bone metastases are as follow: femur - 49 cases, humerus - 10, tibia - 3. After being accepted to operavite treatment, the patients had been cured as quickly as possible - sometimes during emergency service. In 2 cases with metastases in the tibia there were amputations made in femur regions. In remainq patients we made local excisions of metastatic tumours with internal osteosynthesis and bone cement application in 47 cases, with internal osteosynthesis only in 7 cases, with hip arthroplasty in 8 cases. Results. We have poor results in 4,8%, because of the death of 3 patients. Mean time of follow-up since surgical procedure was 6 months. In 82,3% we have very good or good results - no pain, good function and independence in daily activities. Mean survival time is 17,5 months (range: 5-36 months). Conclusions. Efficacy of the surgical procedures of pathological fracures due to bone metastases in reliving the pain, improvement of patients' mobility and activiteis of day living are very good. Mean time of survival after surgical treatment of pathological fracture due to bone metastases in study group justifies its applications in spite of higher rate of general complications.