CAJ | 학술논문

背景:骨盆是溶骨肿瘤常见发生部位,经皮骨水泥注射到病灶部位能达到稳定骨折,减轻疼痛甚或治疗肿瘤的作用,但骨水泥泄漏能引起严重并发症.目的:探讨应用CT导引下经皮穿刺骨水泥注射治疗9例骨盆部位溶骨病变的方法以及治疗效果.方法:在CT导引下,首先确定进针点和进针角度,按照病灶的大小和扫描的层数,计算病灶的容积,估计骨水泥的注射剂量.然后使用自行设计的三维穿刺导向器引导穿刺,按照手术前计算的容积略少于计算量0.2～0.5 mL注射骨水泥到骨盆溶骨破坏部位,充填满意后退出穿刺针.对穿刺的准确性、注射剂量、临床效果以及并发症进行观察和探讨.结果与结论:全部病例完成5个月～4年,平均1.5年随访.手术后1～48 h症状缓解,完全缓解6例,部分缓解2例,轻微缓解1例.手术后CT扫描无病灶周围泄漏.提示经皮穿刺骨水泥注射是治疗不适应手术切除的骨盆溶骨病变的有效方法,具有安全、见效快、创伤小等优点.
배경:골분시용골종류상견발생부위,경피골수니주사도병조부위능체도은정골절,감경동통심혹치료종류적작용,단골수니설루능인기엄중병발증.목적:탐토응용CT도인하경피천자골수니주사치료9례골분부위용골병변적방법이급치료효과.방법:재CT도인하,수선학정진침점화진침각도,안조병조적대소화소묘적층수,계산병조적용적,고계골수니적주사제량.연후사용자행설계적삼유천자도향기인도천자,안조수술전계산적용적략소우계산량0.2～0.5 mL주사골수니도골분용골파배부위,충전만의후퇴출천자침.대천자적준학성、주사제량、림상효과이급병발증진행관찰화탐토.결과여결론:전부병례완성5개월～4년,평균1.5년수방.수술후1～48 h증상완해,완전완해6례,부분완해2례,경미완해1례.수술후CT소묘무병조주위설루.제시경피천자골수니주사시치료불괄응수술절제적골분용골병변적유효방법,구유안전、견효쾌、창상소등우점.
BACKGROUND: Osteolysis has always occurred in pelvis. Percutaneous injection of bone cement stabilized bone fracture, relieved pain or even treated tumor. However, leakage of bone cement might cause severe complications. OBJECTIVE: To explore the therapeutic effect of peroutaneous injection of bone cement on treating osteolysis pelvic disease in 9 cases by the CT guidance. METHODS: By the CT guidance, needing degree was determined firstly. Focal size and scanning layers were used to calculate focal volume and estimate injected dose of bone cement. Three-dimensional targeting device was used to introduce the puncturation. The bone cement which was 0.2-0.5 mL less than the calculated volume was injected into osteolysis site. The accuracy, injected dose, clinical efficacy, and complications were investigated. RESULTS AND CONCLUSION: The following-up ranged from 5 months to 4 years, with mean duration of 1.5 years. At 1-48 hours after operation, symptoms were recovered, including complete recovery (n=6), partial recovery (n=2), and light recovery (n=1). Leakage of bone cement was not detected out around focal region. This suggested that percutaneous injection of bone cement into the erosion site is an effective method to treat pelvic osteolysis disease, characterizing by security, effective, and less invasive.