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目的评价开展股骨上段转移性肿瘤人工髋关节置换术前行介入栓塞化疗的临床价值。方法对拟行人工髋关节置换的6例转移性股骨上段肿瘤患者,手术前10~14 d行超选择性动脉插管肿瘤介入栓塞化疗,对不同性质来源的肿瘤采用不同的化疗药物。结果所有经介入治疗的患者疼痛症状缓解或消失,肿瘤(包括软组织肿块)有明显的缩小,肿瘤供血动脉数量减少,血管内有新鲜血栓形成,肿瘤边界清晰,2例患者无新的骨质破坏,病理结果显示肿瘤细胞大量坏死,瘤体周围有炎细胞浸润,换髋手术顺利。结论对股骨上段转移性肿瘤人工髋关节置换术前行超选择动脉插管介入栓塞化疗,具有显著的临床价值。
Objective To evaluate the clinical value of interventional embolization chemotherapy for the treatment of metastatic femoral head arthroplasty before artificial hip arthroplasty. Methods Six patients with metastatic femoral head tumors who underwent total hip arthroplasty were treated with superselective arterial intubation and embolization chemotherapy 10 to 14 days before surgery. Different chemotherapeutic agents were used for tumors of different origins. Results All the patients underwent interventional treatment to relieve or disappear the pain symptoms. The tumor (including soft tissue mass) was significantly reduced, the number of tumor feeding arteries was reduced, there was a fresh thrombus in the blood vessel, the tumor boundary was clear, and 2 patients had no new bone destruction Pathological results showed a large number of tumor necrosis, inflammatory cell infiltration around the tumor for hip surgery smoothly. Conclusion There is a significant clinical value of superselective arterial cannulation and interventional chemoembolization before artificial hip arthroplasty for metastatic tumors of the femur.