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目的 采用微波对肿瘤瘤段骨进行原位热疗，灭活其中的肿瘤细胞，避免骨肿瘤切除后所造成的骨缺损。方法 自 1980年以来，对 89例四肢骨肿瘤患者采用肿瘤局部切除加术中微波原位热疗进行保肢手术，男 52例，女 37例；年龄 10～ 46岁，中位年龄 18.9岁。肿瘤性质 :骨肉瘤 51例，皮质旁骨肉瘤 12例，软骨肉瘤 9例，骨巨细胞瘤 6例，恶性纤维组织细胞瘤 3例，平滑肌肉瘤、转移癌和 Ewing肉瘤各 2例，淋巴瘤和滑膜肉瘤各 1例。肿瘤部位 :近关节端 68例，其中股骨下端 39例，胫骨上端 24例，肱骨近端 5例；骨干 11例，其中股骨干 6例，胫骨干 4例，桡骨干 1例；扁状骨 10例，其中骨盆和肩胛骨各 5例。肿瘤分期为：Ⅱ A期 23例，Ⅱ B期 63例，Ⅲ B期 3例。术中根据肿瘤所在的部位，如近关节端、骨干或骨盆和肩胛骨，按肿瘤广泛切除原则，选择显露、切除方法。将肿瘤瘤段骨及其周围部分正常骨干显露，用铜网保护周围正常软组织，利用 2 450 MHz微波加热 50℃， 15 min，灭活肿瘤瘤段骨内的肿瘤细胞。结果 本组随访 6个月～ 20年，平均 4.5年。五年生存率为 64.49％，局部复发 9例，复发率为 10.1％。 10例发生了 11例次并发症 (12.4％ )。功能评价为
Objective To use microwave to treat bone tumor in situ with in situ hyperthermia, inactivate the tumor cells and avoid the bone defect after bone tumor resection. Methods Since 1980, 89 cases of patients with bone tumors of the limbs were treated with local tumor resection and intraoperative microwave in situ hyperthermia for limb salvage operation. There were 52 males and 37 females; their age ranged from 10 to 46 years and their median age was 18.9 years. Tumor properties: 51 cases of osteosarcoma, 12 cases of paracortical osteosarcoma, 9 cases of chondrosarcoma, 6 cases of giant cell tumor of bone, 3 cases of malignant fibrous histocytoma, 2 cases of leiomyosarcoma, metastatic carcinoma and 2 cases of Ewing sarcoma, and 1 case of lymphoma. One case of synovial sarcoma. Tumor sites: 68 proximal joints, 39 in the lower femur, 24 in the upper tibia, 5 in the proximal humerus, and 11 in the diaphyseal, including 6 in the femoral shaft, 4 in the humerus, and 1 in the humerus. Flattened bone 10 Examples include 5 cases of pelvis and scapula. The tumor stage was: 23 cases in stage II A, 63 cases in stage II B, and 3 cases in stage III B. According to the location of the tumor, such as the proximal joint, the backbone, or the pelvis and scapula, the principle of extensive resection of the tumor is to select the method of exposure and resection. The normal bone of the tumor segment and its surrounding part was exposed, and the surrounding soft tissue was protected with a copper mesh. The tumor cells in the tumor segment were inactivated by heating at 50° C. for 15 min with 2 450 MHz microwave. Results The group was followed up for 6 months to 20 years with an average of 4.5 years. The five-year survival rate was 64.49%, 9 cases had local recurrence, and the recurrence rate was 10.1%. In 10 cases, 11 cases of complications occurred (12.4%). Functional evaluation is