上海市第一人民医院骨肿瘤科;上海市骨肿瘤研究所;
目的：分析膝关节周围原发恶性肿瘤保肢术后切口愈合不良的危险因素。方法：回顾性分析2019年1月至2022年12月上海市第一人民医院收治的接受保肢手术的83例膝关节周围原发恶性肿瘤患者的临床资料。对患者以下指标进行分析，包括年龄，性别，肿瘤部位，保肢术前化疗周期、骨髓抑制情况及是否使用靶向药物，保肢术前白蛋白、血红蛋白水平，保肢手术时间，保肢术后引流时间、输血量，以及肿瘤侵犯股四头肌数目。采用单因素Logistic回归分析筛选膝关节周围原发恶性肿瘤保肢术后切口愈合不良的危险因素。结果：本研究83例患者随访4～51个月，中位数（四分位数）为23(17,34)个月。术后切口愈合不良9例（10.8%），其中4例切口边缘皮肤坏死通过定期换药、3例皮瓣坏死通过清创或皮瓣转位、1例感染和窦道形成通过彻底清创灌洗，均治愈；另1例感染和窦道形成清创灌洗失败后，患者拒绝再次手术，带菌生存。单因素Logistic回归分析结果显示，患者年龄<18岁[优势比（OR）=0.614,95%置信区间（95%CI）:0.419～0.900,P=0.012]、保肢术前骨髓抑制3～4度（OR=9.385,95%CI:2.074～42.460,P=0.004）及肿瘤侵犯股四头肌数目≥3个（OR=4.917,95%CI:1.175～20.580,P=0.029）是膝关节周围原发恶性肿瘤保肢术后切口愈合不良的危险因素。结论：早期识别切口愈合不良的危险因素，并采取针对性的治疗措施，保证切口顺利愈合，对促进膝关节周围原发恶性肿瘤患者康复和提高肿瘤预后有重要的临床意义。
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基本信息:
DOI：
中图分类号:R738.2
引用信息:
[1]汪红胜,沈嘉康,左冬青等.膝关节周围恶性肿瘤保肢术后切口愈合不良的危险因素分析[J].中华骨与关节外科杂志,2025,18(03):237-242.
基金信息:
上海市卫生健康委员会卫生行业临床研究专项基金（20224Y0219）