摘要目的 探讨股骨近端病变的诊断、治疗及预后。方法 对2001年1月至2014年12月在我院诊治的158例股骨近端病变进行回顾性分析。恶性肿瘤36例，良性病变122例。恶性肿瘤主要采取瘤段扩大切除髋关节假体置换术。良性病变的手术治疗主要采取病变刮除植骨内固定术，良性侵袭性肿瘤选择瘤段切除髋关节假体置换术。结果 随访6～60个月，平均29个月，共19例失访。6例良性病变术后出现复发，恶性肿瘤中6例死亡，8例局部复发，6例出现肺转移。术后根据国际保肢学会(international society of limb salvage，ISOLS)功能评分，良性病变平均25.1分；恶性肿瘤平均19.7分。结论 根据股骨近端病变的病理性质、病变范围选择个体化手术治疗，以减少局部病变复发，提高患者髋关节功能及改善预后。良恶性病变均可通过手术治疗获得满意的髋关节功能。
Abstract：Objective To investigate the diagnosis，treatment and prognosis of lesions in proximal femoral.Methods 158 patients with proximal femoral lesions in our hospital fromJanuary 2001 to December 2014 were analyzed retrospectively.36 cases was diagnosed malignant tumors，and 122 cases was diagnosedbenign lesions.Malignant tumor mainly adopted the extended resection of tumor sections with hip arthroplasty.The surgical treatment of benign lesions mainly took the lesions scraping in addition to graft bone with internal fixation.Aggressive benign tumors received tumor segment resection and prosthetic replacement of hip joint.Results Followed up for 6 to 60 months，with an average of 29 months，19 cases were lost.6 cases of benign lesions developed postoperative recurrence.6 cases of malignant tumorsdied，8 cases appeared local recurrence，6 cases developed pulmonary metastasis.According to ISOLS score，the average score of benign lesion was 25.1，and malignant tumors was 19.7.Conclusion In order to reduce local disease recurrence and improve the patient's hip function and improve prognosis，the surgical treatments should be based on the pathological characteristics and the scope of proximal femoral lesions.Whether benign lesions and malignant tumors，patients could acquiregood hip joint function by surgery.
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