【摘要】 目的 探讨在保留膝关节韧带和半月板的条件下利用微波对膝关节周围恶性骨肿瘤进行原位热疗保肢治疗的临床效果及价值。方法 对43例股骨远端或胫骨近端恶性骨肿瘤行原位微波热疗，用Enneking肢体恶性肿瘤保肢术后功能评价系统对膝关节功能进行评分。结果 术后感染3例，大动脉血栓1例，这4例均截肢，43例中10例失访，其余29例随访5～8年，Enneking评分平均为21.6，膝关节活动度为伸0°，屈70°～150°，屈膝达90°及以上者为23例(79.3%);灭活骨段骨折3例，肿瘤复发4例，转移7例，复发并转移5例。其中骨肉瘤组5年生存率为57.9%。结论 微波原位热疗具有手术操作简便、疗效可靠、易于推广等优点，是一种较为理想的保肢手术方法，尤其适合于骨破坏较轻，骨支架作用基本保留者。

    关键词 肿瘤 膝关节 微波热疗

    A study of clinical therapeutic effect and late follow-up survey on microwave heliotherapy of

    malignant tumors around knee joints for reserving functions of ligaments and meniscus

    Yang Zhiping，Li Jianmin，Li Xin，et al.

    Dept.of Orthopedics，QiLu Hospital of Shangdong University，Jinan250012.

    【Abstract】 Objective To study the clinical application of microwave in treatment of malignant tumors around knee joints with the purpose of killing the tumor cells in situ and reserving the ligaments and meniscus for limb salˉvage.Methods Microwave heliotherapy was performed in situ for43malignant tumors in lower part of femur or upper part of tibia.The function of knee jointwas evaluated according to Enneking system.Results Amputation was underˉtaken in3patients for infections and1patient for thrombus in big artery.10cases lost in follow-up ......