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目的:分析骨肉瘤患者接受瘤段灭活再植的术后并发症,评价该术式的临床价值。方法:1986年11月到1989年7月,39例肢体骨肉瘤患者行瘤段灭活再植术,平均随访43.5个月。瘤段灭活方法为液态氮冷冻24例,60Co照射13例,煮沸2例。结果:（1）29名患者发生了41例次的术后并发症,发生率为74.4％。11名患者因术后感染、肿瘤局部复发等原因而截肢。术后总评优良率为41.0％。（2）瘤段灭活再植术后主要并发症的发生率:肿瘤局部复发33.3％,术后感染15.4％,皮瓣坏死7.7％,骨折25.6％,骨不连10.3％。结论:采用液态氮冷冻、60Co照射、煮沸等方法行瘤段灭活再植,术后并发症发生率高,患者肢体功能较差。
Objective: To analyze the postoperative complications of inactivation and replantation of tumor segments in patients with osteosarcoma and evaluate the clinical value of this procedure. Methods: From November 1986 to July 1989, 39 patients with limb osteosarcoma were treated with tumor resection and inactivation. The average follow-up time was 43.5 months. The tumor segment inactivation method was liquid nitrogen freezing in 24 cases, 60Co irradiation in 13 cases, and boiling in 2 cases. Results: (1) There were 41 cases of postoperative complications in 29 patients, the incidence was 74.4%. Eleven patients were amputated due to postoperative infections, local tumor recurrence, and other causes. The overall excellent rate after surgery was 41.0%. (2) The incidence of major complications after tumor replantation was tumor recurrence 33.3%, postoperative infection 15.4%, flap necrosis 7.7%, fracture 25.6%, nonunion 10.3%. Conclusion: Inactivation and replantation of tumor segments with liquid nitrogen freezing, 60Co irradiation, and boiling methods have high postoperative complications and poor limb function.