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目的探讨围术期康复治疗对骨盆恶性肿瘤半骨盆切除、组配式半骨盆+全髋关节置换术后的患肢功能的影响。方法 2004年9月—2007年5月采用半骨盆切除、组配式半骨盆假体+全髋关节置换术治疗骨盆恶性骨肿瘤8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,下床负重时间和步态调整。结果随访8～30个月,平均13个月。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19.5分。结论①术后患者的合理体位和良好的支具保护能有效的防止髋关节早期脱位;②患肢各关节的分阶段有序的主动训练能提高骨盆和髋周肌肉肌力及其平衡度,对术后患者行走和步态有重要意义。
Objective To investigate the effect of perioperative rehabilitation on the function of the affected limbs after hemi pelvic resection of pelvic cancer and combined hemipelvic + total hip arthroplasty. Methods From September 2004 to May 2007, 8 cases of pelvic malignant bone tumors were treated with semi - pelvic excision and combined hemi - pelvic prosthesis + total hip arthroplasty. According to the tumor resection scope, the stability after prosthesis replacement and the balance after pelvic hip muscle repair, the position of the affected limb, the scope of hip movement, whether to use the hip brace or not, and the patient’s score Phase, progressive limb ankle, knee, hip and the main passive training, bed load time and gait adjustment. The results were followed up for 8 to 30 months, an average of 13 months. 8 months after limb function assessment: excellent in 2 cases, good in 6 cases. ISOLS score: 15 to 26 points, an average of 19.5 points. Conclusions ① Postoperative patients with a reasonable position and good braces can effectively prevent the early dislocation of the hip; ② phalanx orderly active training of the joints of the limbs can improve pelvic and hip muscle strength and balance, Postoperative patients walking and gait is of great significance.