中国中西医结合外科杂志
中國中西醫結閤外科雜誌
중국중서의결합외과잡지
CHINESE JOURNAL OF SURGERY OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2014年
1期
31-34
,共4页
赵晓峰%龚剑秋%钱宇%张军
趙曉峰%龔劍鞦%錢宇%張軍
조효봉%공검추%전우%장군
椎体后凸成形术%椎体转移性肿瘤%双侧通道%骨水泥渗漏
椎體後凸成形術%椎體轉移性腫瘤%雙側通道%骨水泥滲漏
추체후철성형술%추체전이성종류%쌍측통도%골수니삼루
Kyphoplasty%vertebral metastatic tumor%bilateral channels%leakage
目的：探讨经皮双侧椎弓根通道椎体后凸成形术在胸腰椎椎体转移性肿瘤治疗中的临床疗效和安全性。方法：对17例胸腰椎椎体转移性肿瘤患者共25椎节行经皮双侧椎弓根通道球囊扩张，骨水泥注入。对患者疼痛程度及功能障碍情况分别采用视觉模拟评分和功能障碍指数于治疗前后进行评估。对骨水泥渗漏情况，各例术后以正侧位X线平片判断骨水泥渗漏为X线平片渗漏率，以注射节段CT薄层扫描评判骨水泥渗漏为CT渗漏率,进行统计计算。结果：所有患者均顺利完成手术，无一例症状性骨水泥渗漏发生。术后胸腰背痛缓解明显。VAS评分术前为（7.2±1.1）分、术后3 d内为（2.3±0.9）分、术后3个月为（2.5±1.1）分。ODI 评分术前为（70.1±1.1）分、术后3 d内为（33.1±1.2）分、术后3个月为（35.2±1.4）分。计算得骨水泥X线平片渗漏率为32%，CT渗漏率为38%。结论：经皮椎体后凸成形术可有效缓解椎体转移性肿瘤患者腰背部疼痛，改善患者日常生活功能；双侧穿刺通道可降低骨水泥渗漏率及减少症状性骨水泥渗漏发生。
目的：探討經皮雙側椎弓根通道椎體後凸成形術在胸腰椎椎體轉移性腫瘤治療中的臨床療效和安全性。方法：對17例胸腰椎椎體轉移性腫瘤患者共25椎節行經皮雙側椎弓根通道毬囊擴張，骨水泥註入。對患者疼痛程度及功能障礙情況分彆採用視覺模擬評分和功能障礙指數于治療前後進行評估。對骨水泥滲漏情況，各例術後以正側位X線平片判斷骨水泥滲漏為X線平片滲漏率，以註射節段CT薄層掃描評判骨水泥滲漏為CT滲漏率,進行統計計算。結果：所有患者均順利完成手術，無一例癥狀性骨水泥滲漏髮生。術後胸腰揹痛緩解明顯。VAS評分術前為（7.2±1.1）分、術後3 d內為（2.3±0.9）分、術後3箇月為（2.5±1.1）分。ODI 評分術前為（70.1±1.1）分、術後3 d內為（33.1±1.2）分、術後3箇月為（35.2±1.4）分。計算得骨水泥X線平片滲漏率為32%，CT滲漏率為38%。結論：經皮椎體後凸成形術可有效緩解椎體轉移性腫瘤患者腰揹部疼痛，改善患者日常生活功能；雙側穿刺通道可降低骨水泥滲漏率及減少癥狀性骨水泥滲漏髮生。
목적：탐토경피쌍측추궁근통도추체후철성형술재흉요추추체전이성종류치료중적림상료효화안전성。방법：대17례흉요추추체전이성종류환자공25추절행경피쌍측추궁근통도구낭확장，골수니주입。대환자동통정도급공능장애정황분별채용시각모의평분화공능장애지수우치료전후진행평고。대골수니삼루정황，각례술후이정측위X선평편판단골수니삼루위X선평편삼루솔，이주사절단CT박층소묘평판골수니삼루위CT삼루솔,진행통계계산。결과：소유환자균순리완성수술，무일례증상성골수니삼루발생。술후흉요배통완해명현。VAS평분술전위（7.2±1.1）분、술후3 d내위（2.3±0.9）분、술후3개월위（2.5±1.1）분。ODI 평분술전위（70.1±1.1）분、술후3 d내위（33.1±1.2）분、술후3개월위（35.2±1.4）분。계산득골수니X선평편삼루솔위32%，CT삼루솔위38%。결론：경피추체후철성형술가유효완해추체전이성종류환자요배부동통，개선환자일상생활공능；쌍측천자통도가강저골수니삼루솔급감소증상성골수니삼루발생。
Objective To investigate the clinical efficacy and safety of the kyphoplasty via percutaneous bi-lateral pedicle channels in the treatment for thoracolumbar vertebral metastatic tumor. Methods Totally 17 cases,and 25 vertebral segments with thoracolumbar vertebral metastatic tumors underwent kyphoplasty via bilat-eral pedicle channel, balloon expansion, and bone cement injection. The degree of pain and dysfunction of pa-tients were assessed with visual analogue scale before and after treatment. Lateral view of X-ray plain film was used to assess the leakage situation of bone cement for all the cases postoperatively. Fine cut CT scanning of the injected segments was used to assess the leakage of bone cement. Results All patients underwent the sur-geries, and no symptomatic bone cement leakage occurred. The preoprative VAS was 7.2±1.1, and VAS ws 2.3± 0.9 and 35.2±1.4 at 3 days and 3 months postoperatively respectively.The leakage rate was 32% based on X-ray and 38% based on CT scanning. Conclusion the kyphoplasty via percutaneous bilateral pedicle channels will reduce the pain of the thoracolumbar vertebral metastatic tumor effectively.
