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目的：探讨胫骨上端骨肉瘤保肢手术中使用人工关节重建的疗效和并发症。方法：回顾性分析2000 年6 月～2010 年6 月对 21 例胫骨上段骨肉瘤患者行根治性切除人工关节重建手术的临床资料，其中男性13 例, 女性8 例，年龄21-62 岁，平均34.1 岁。依据Enneking 分期:ⅡA 期12 例、ⅡB 期9 例。均采用广泛性边缘切除手术治疗。所有患者均接受术前、术后化疗。结果：1 例患者发生术后胫前肌群坏死。所有患者均随访6-72 个月, 平均45.1 个月。ⅡA 期12 例患者中，1 例因肺转移死亡(占8.3%)，局部复发1 例,行股骨下段截肢，10 例无病生存；ⅡB 期9 例，4 例死亡，5 例存活；Enneking 分期明显影响预后。结论：胫骨上段人工关节重建对胫骨上段骨肉瘤的保肢治疗具有良好的疗效。

英文摘要:

Objective: To evaluate the efficacy and complications of osteoarticular allografts in the limb salvage of the proximal tibia .Methods: The clinical data of 21 patients with osteoarticular allografts of the proximal tibia underwent osteoarticular allografts from June 2000 to June 2010，13 males and 8 females，aged 15-78 years old ( averaged, 34.1years)，were analyzed retrospectivelv. All the patients underwent the marginal resection.According to the Enneking system, 13 patients were classified intoⅡA, and 9 patients into Ⅱ B.All patients accepted chemotherapy before and after surgery. Results: All cases were followed up from 6 to 72 months (averaged，45.1 months). In 12 cases of ⅡA，one case (8.3%)developed pulmonary metastasis and died.One had a local recurrence，and underwent amputation at the lower part of the femur．Ten cases remained continuously disease-free.In 9 cases of ⅡB，4 died ，and 5 remained disease-free. Enncking staging was significantly affecting prognosis in patients. Conclusion: The surgical operation combined with the osteoarticular allografts is an ideal treatment method for the proximal tibia osteosarcomas.

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