肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2011年
12期
832-835
,共4页
脊柱肿瘤%经皮椎体后凸成形术%骨水泥%治疗结果
脊柱腫瘤%經皮椎體後凸成形術%骨水泥%治療結果
척주종류%경피추체후철성형술%골수니%치료결과
Spinal neoplasms%Percutaneous kyphoplasty%Bone cement%Treatment outcome
目的 观察接受经皮椎体后凸成形术( PKP)治疗的胸腰椎溶骨性肿瘤患者疼痛及日常活动的改善情况.方法 回顾性分析接受PKP治疗的胸腰椎溶骨性肿瘤患者35例,术前均有顽固性背痛,CT及MRI提示椎体溶骨性病变.在C型臂下行椎弓根穿刺球囊扩张椎体后注射骨水泥,采用视觉模拟评分( VAS)、WHO疼痛缓解标准及Owestry功能障碍指数(ODI)于术后1d、1个月、6个月评估疼痛缓解及日常活动功能恢复情况,并对病椎的高度变化进行分析,记录骨水泥外漏情况.采用t检验进行统计学分析.结果 35例患者术后24 h内疼痛缓解,无脊髓或神经根损伤及压迫症状,复查X线片见椎体内骨水泥填充良好.手术前后VAS(7.52±0.81比4.31 ±0.32)、ODI(69.45±0.87比54.45±0.85)和病椎高度[(2.0±0.5)mm比(2.7±0.4) mm]比较,差异均有统计学意义(t值分别为-7.34、-5.32和-3.36,均P＜0.05).术后随访6个月疼痛缓解及日常活动功能改善趋于稳定.术后1d、1个月、6个月疼痛缓解率分别为80.0％(28/35)、85.7％(30/35)及82.8 ％(29/35).结论 PKP能迅速缓解胸腰椎溶骨性肿瘤引起的疼痛,有效恢复病椎高度,并发症相对较少,提高患者生存质量.
目的 觀察接受經皮椎體後凸成形術( PKP)治療的胸腰椎溶骨性腫瘤患者疼痛及日常活動的改善情況.方法 迴顧性分析接受PKP治療的胸腰椎溶骨性腫瘤患者35例,術前均有頑固性揹痛,CT及MRI提示椎體溶骨性病變.在C型臂下行椎弓根穿刺毬囊擴張椎體後註射骨水泥,採用視覺模擬評分( VAS)、WHO疼痛緩解標準及Owestry功能障礙指數(ODI)于術後1d、1箇月、6箇月評估疼痛緩解及日常活動功能恢複情況,併對病椎的高度變化進行分析,記錄骨水泥外漏情況.採用t檢驗進行統計學分析.結果 35例患者術後24 h內疼痛緩解,無脊髓或神經根損傷及壓迫癥狀,複查X線片見椎體內骨水泥填充良好.手術前後VAS(7.52±0.81比4.31 ±0.32)、ODI(69.45±0.87比54.45±0.85)和病椎高度[(2.0±0.5)mm比(2.7±0.4) mm]比較,差異均有統計學意義(t值分彆為-7.34、-5.32和-3.36,均P＜0.05).術後隨訪6箇月疼痛緩解及日常活動功能改善趨于穩定.術後1d、1箇月、6箇月疼痛緩解率分彆為80.0％(28/35)、85.7％(30/35)及82.8 ％(29/35).結論 PKP能迅速緩解胸腰椎溶骨性腫瘤引起的疼痛,有效恢複病椎高度,併髮癥相對較少,提高患者生存質量.
목적 관찰접수경피추체후철성형술( PKP)치료적흉요추용골성종류환자동통급일상활동적개선정황.방법 회고성분석접수PKP치료적흉요추용골성종류환자35례,술전균유완고성배통,CT급MRI제시추체용골성병변.재C형비하행추궁근천자구낭확장추체후주사골수니,채용시각모의평분( VAS)、WHO동통완해표준급Owestry공능장애지수(ODI)우술후1d、1개월、6개월평고동통완해급일상활동공능회복정황,병대병추적고도변화진행분석,기록골수니외루정황.채용t검험진행통계학분석.결과 35례환자술후24 h내동통완해,무척수혹신경근손상급압박증상,복사X선편견추체내골수니전충량호.수술전후VAS(7.52±0.81비4.31 ±0.32)、ODI(69.45±0.87비54.45±0.85)화병추고도[(2.0±0.5)mm비(2.7±0.4) mm]비교,차이균유통계학의의(t치분별위-7.34、-5.32화-3.36,균P＜0.05).술후수방6개월동통완해급일상활동공능개선추우은정.술후1d、1개월、6개월동통완해솔분별위80.0％(28/35)、85.7％(30/35)급82.8 ％(29/35).결론 PKP능신속완해흉요추용골성종류인기적동통,유효회복병추고도,병발증상대교소,제고환자생존질량.
Objective To evaluate the relief of pain and daily activities in patients with osteolytic tumor of thoracic lumbar vertebrae by percutaneous kyphoplasty (PKP).Methods A retrospective study was conducted to review 35 cases of osteolytic tumor of vertebrae treated with PKP.All patients had a refractories back pain while CT and MRI showed osteolytic changes in their vertebrae. The operation involved percutaneously inserting inflatable vertebral body and creating a cavity filled with bone cement.The visual analogue scales (VAS),WHO standards for pain relief and owestry disability index (ODI) were recorded after the procedures.The change of height in abnormal vertebrae and status of postoperative leakage of PMMA were also recorded.These data were followed up after 1 day,1 month and 6 months and analyzed via t student test.Results The total 35 operations were done successfully.All patients got a conspicuous pain relief at 24 h after operation,and no spinal injury or compression was found.The X-ray showed that the vertebrates treated were filled well by cerment.There were significant differences at pain levels [(7.52±0.81) vs (4.31±0.32)],locomotor activity scales (ODI) [(69.45±0.87) vs (54.45±0.85)] and the height of vertebral bodies [(2.0±0.5) mm vs (2.7±0.4) mm] before and after operation (t value was -7.34,-5.32 and -3.36,respectively,P ＜ 0.05).At 6 months,follow up studies showed that clinic therapeutic effects were stabled for odynolysis and locomotor activity scales.The rates of pain relief in 24 h,1 month and 6 months were 80.0 ％ (28/35),85.7 ％ (30/35),82.8 ％ (29/35),respectively.Conclusion PKP is a single safe and effective way to treat osteolytic tumor of thoracic lumbar vertebrae.It can simply,quickly,and effectively relief the pain caused by osteolytic spinal tumor,recover height of the abnormal vertebra,and improve patient's life quality safely with less complications.
