介入放射学杂志
介入放射學雜誌
개입방사학잡지
JOURNAL OF INTERVENTIONAL RADIOLOGY
2014年
5期
411-414
,共4页
田庆华%吴春根%顾一峰%王涛%何煜%宋红梅%易飞%何成建%肖全平%程永德
田慶華%吳春根%顧一峰%王濤%何煜%宋紅梅%易飛%何成建%肖全平%程永德
전경화%오춘근%고일봉%왕도%하욱%송홍매%역비%하성건%초전평%정영덕
经皮椎体成形术%脊柱%成骨性转移癌
經皮椎體成形術%脊柱%成骨性轉移癌
경피추체성형술%척주%성골성전이암
percutaneous vertebroplasty%spine%osteoblastic metastasis
目的:探讨DSA引导下经皮椎体成形术(PVP)治疗成骨性脊柱转移癌的可行性及近期临床疗效。方法2010年1月-2011年12月对23例(34个病灶)成骨性脊柱转移癌实施PVP术,其中合并成骨性病理性骨折12例。通过WHO标准、视觉模拟评分(VAS)、体力状况评分(Karnofsky-KPS)的变化情况来评价临床疗效。结果所有患者均获得手术成功,技术成功率100%。术后随访至少3个月。资料完整的20例患者中6例完全缓解(CR),10例部分缓解(PR),3例轻微缓解(MR),1例无效(NR),总有效率(CR+PR)达80.0%。术后24 h VAS评分由术前7.0±1.6分降至2.2±1.9分,术后1、3个月分别降至(2.4±2.1)分、(2.5±2.1)分。术后24 h、1个月、3个月KPS评分由术前(76.5±10.4)分分别升至(86.5±11.8)分、(88.0±12.0)分和(89.0±10.8)分。4例发生少量骨水泥渗漏,但无明显临床症状(17.4%)。结论 DSA引导下对成骨性脊柱转移癌患者行PVP术是可行、有效的,能有效缓解疼痛、稳定脊柱,改善其生活质量,并能降低截瘫发生率。
目的:探討DSA引導下經皮椎體成形術(PVP)治療成骨性脊柱轉移癌的可行性及近期臨床療效。方法2010年1月-2011年12月對23例(34箇病竈)成骨性脊柱轉移癌實施PVP術,其中閤併成骨性病理性骨摺12例。通過WHO標準、視覺模擬評分(VAS)、體力狀況評分(Karnofsky-KPS)的變化情況來評價臨床療效。結果所有患者均穫得手術成功,技術成功率100%。術後隨訪至少3箇月。資料完整的20例患者中6例完全緩解(CR),10例部分緩解(PR),3例輕微緩解(MR),1例無效(NR),總有效率(CR+PR)達80.0%。術後24 h VAS評分由術前7.0±1.6分降至2.2±1.9分,術後1、3箇月分彆降至(2.4±2.1)分、(2.5±2.1)分。術後24 h、1箇月、3箇月KPS評分由術前(76.5±10.4)分分彆升至(86.5±11.8)分、(88.0±12.0)分和(89.0±10.8)分。4例髮生少量骨水泥滲漏,但無明顯臨床癥狀(17.4%)。結論 DSA引導下對成骨性脊柱轉移癌患者行PVP術是可行、有效的,能有效緩解疼痛、穩定脊柱,改善其生活質量,併能降低截癱髮生率。
목적:탐토DSA인도하경피추체성형술(PVP)치료성골성척주전이암적가행성급근기림상료효。방법2010년1월-2011년12월대23례(34개병조)성골성척주전이암실시PVP술,기중합병성골성병이성골절12례。통과WHO표준、시각모의평분(VAS)、체력상황평분(Karnofsky-KPS)적변화정황래평개림상료효。결과소유환자균획득수술성공,기술성공솔100%。술후수방지소3개월。자료완정적20례환자중6례완전완해(CR),10례부분완해(PR),3례경미완해(MR),1례무효(NR),총유효솔(CR+PR)체80.0%。술후24 h VAS평분유술전7.0±1.6분강지2.2±1.9분,술후1、3개월분별강지(2.4±2.1)분、(2.5±2.1)분。술후24 h、1개월、3개월KPS평분유술전(76.5±10.4)분분별승지(86.5±11.8)분、(88.0±12.0)분화(89.0±10.8)분。4례발생소량골수니삼루,단무명현림상증상(17.4%)。결론 DSA인도하대성골성척주전이암환자행PVP술시가행、유효적,능유효완해동통、은정척주,개선기생활질량,병능강저절탄발생솔。
Objective To discuss the feasibility and short-term clinical effectiveness of DSA-guided percutaneous vertebroplasty (PVP) for the treatment of painful osteoblastic metastatic spinal lesions. Methods During the period from Jan. 2010 to Dec. 2011 at authors’ hospital PVP was carried out in 23 patients with osteoblastic spinal metastases (34 lesions in total). Coexisting osteoblastic pathological fracture was found in twelve patients. The WHO standards, visual analogue scale (VAS) and karnofsky-KPS score were used to evaluate the therapeutic results. Results Technical success was achieved in all patients. All patients were followed up for at least 3 months. Of 20 patients who had complete clinical data, complete remission (CR) was obtained in 6, partial remission (PR) in 10, mild remission (MR) in 3 and no remission (NR) in one. The clinical effectiveness (CR+PR) was 80%. The mean VAS scores dropped from preoperative (7.0 ± 1.6) to (2.2 ± 1.9) at 24 hours after the treatment, and to (2.4 ± 2.1) and (2.5 ± 2.1) at one and three months after the treatment respectively. The mean KPS scores rose from preoperative (76.5 ± 10.4) to (86.5 ± 11.8), (88.0 ± 12.0) and (89.0 ± 10.8) at 24 hours and one, three months after the treatment respectively. Small amount leakage of PMMA was observed in 4 cases (17.4%) with no obvious clinical symptoms. Conclusion DSA-guided PVP is a feasible and effective treatment for painful osteoblastic spinal metastases. This therapy can immediately relieve pain and reinforce spine, besides, it can remarkably improve the living quality and <br> decrease the incidence of paraplegia.