CAJ | 학술논문

目的:探讨经皮椎体成形术(PVP)治疗多发性胸椎转移瘤的临床疗效.方法:对28例多发性胸椎转移瘤患者的104个椎体在G型臂X线机透视下经皮椎体穿刺并注入聚甲基丙烯酸甲酯(PMMA)骨水泥成形,术后1周、3个月、6个月、12个月时对疼痛缓解程度应用视觉模拟评分法进行评估分级.术后1年时用日常生活自理能力(ADL)量表对治疗后患者生活质量进行评估,同时观察术后病椎椎体形态学变化和椎管内肿瘤的浸润程度.结果:104个椎体穿刺全部成功,1例1个椎体有骨水泥进入相邻椎间盘,无椎管内渗漏和肺栓塞等并发症.PVP后各时间点疼痛缓解率均>80%;术后1年时生活质量评分明显高于术前(P<0.01).PVP术后1年时椎体前缘、中央、后缘高度与PVP前无差异(P>0.05);4例患者的5个病椎有椎弓根的浸润并突人椎管内,其余椎体和附件未见肿瘤进一步浸润.结论:经皮穿刺椎体成形术治疗多发性胸椎转移瘤安全可行,具有良好的止痛效果,能够有效改善患者的生活质量,并可显著预防椎体进一步塌陷,同时延缓和降低了椎管内肿瘤浸润的发生.
목적:탐토경피추체성형술(PVP)치료다발성흉추전이류적림상료효.방법:대28례다발성흉추전이류환자적104개추체재G형비X선궤투시하경피추체천자병주입취갑기병희산갑지(PMMA)골수니성형,술후1주、3개월、6개월、12개월시대동통완해정도응용시각모의평분법진행평고분급.술후1년시용일상생활자리능력(ADL)량표대치료후환자생활질량진행평고,동시관찰술후병추추체형태학변화화추관내종류적침윤정도.결과:104개추체천자전부성공,1례1개추체유골수니진입상린추간반,무추관내삼루화폐전새등병발증.PVP후각시간점동통완해솔균>80%;술후1년시생활질량평분명현고우술전(P<0.01).PVP술후1년시추체전연、중앙、후연고도여PVP전무차이(P>0.05);4례환자적5개병추유추궁근적침윤병돌인추관내,기여추체화부건미견종류진일보침윤.결론:경피천자추체성형술치료다발성흉추전이류안전가행,구유량호적지통효과,능구유효개선환자적생활질량,병가현저예방추체진일보탑함,동시연완화강저료추관내종류침윤적발생.
Objectlve:To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) for multiple thoracic vertebral metastases.Method:A total of 104 thoracic vertebral from 28 patients suffering from metas-tases underwent percutaneous vertebroplasty (Polymethyl methacrylate,PMMA) under fluoroscopy.The clinical outcome was self-measured by VAS scale at 1 week,3 months,6 months and 1 year respectively,and by ac-tivity of daily life(ADL) system at 1 year,the morphology of revolved vertebral and infiltration of tumor into spinal canal was observed either.Result:All cases underwent surgery successfully,no serious neurological and pulmonary complications relative to PVP except bone cement leakage into adjacent disc.Pain relief beyond 80% was reached at any time point.ADL score of 1 year showed remarkable higher of postoperative than preoperative (P<0.01).The height of the veterbral body (anterior,median and posterior) showed no significant difference during 12 months of follow-up (P>0.05).5 thoracic vertebras from 4 patients had the tumor infiltra-tion into pediele and spinal eanal.Conclusion:PVP is a reliable and safe procedure for multiple thoracic ver-tebral metastases,which is effective in pain relief and improving of life quality as well as preventing of verte-bral collapse,it also can delay and reduce the neoplasm infiltration at the same time.