CAJ | 학술논문

目的：探讨CT引导下应用射频消融术（RFA）治疗股骨颈骨样骨瘤的可行性、安全性，并评估其疗效。方法对6例股骨颈骨样骨瘤患者采用CT引导下经皮穿刺RFA术治疗。患者均以髋关节疼痛症状为主，病程1个月～2年，平均8个月。手术在腰麻下进行，术中于 CT 引导下应用直径3.5～4.0 mm穿刺针穿入瘤巢中心，用骨活检针刮取肿瘤组织送病理学检查。再将有效治疗直径1.5～2.0 cm的射频电极准确插入瘤巢中心，治疗温度90℃持续6 min。术后以疼痛视觉拟评分（VAS）作为临床疗效评定参数。手术前后行MRI检查，进行影像学对比。结果术后3 d疼痛不同程度缓解，术后1周内均能下床行走。VAS评分明显降低，差异有统计学意义（P<0.01）。术中、术后均未见严重并发症，随访期间内无复发。结论 CT引导下经皮穿刺RFA治疗股骨颈骨样骨瘤是一种安全、有效的微创方法，术后并发症少，临床疗效良好。
목적：탐토CT인도하응용사빈소융술（RFA）치료고골경골양골류적가행성、안전성，병평고기료효。방법대6례고골경골양골류환자채용CT인도하경피천자RFA술치료。환자균이관관절동통증상위주，병정1개월～2년，평균8개월。수술재요마하진행，술중우 CT 인도하응용직경3.5～4.0 mm천자침천입류소중심，용골활검침괄취종류조직송병이학검사。재장유효치료직경1.5～2.0 cm적사빈전겁준학삽입류소중심，치료온도90℃지속6 min。술후이동통시각의평분（VAS）작위림상료효평정삼수。수술전후행MRI검사，진행영상학대비。결과술후3 d동통불동정도완해，술후1주내균능하상행주。VAS평분명현강저，차이유통계학의의（P<0.01）。술중、술후균미견엄중병발증，수방기간내무복발。결론 CT인도하경피천자RFA치료고골경골양골류시일충안전、유효적미창방법，술후병발증소，림상료효량호。
Objective To evaluate the feasibility, safety and efficacy of CT-guided radiofrequency ablation in treating osteoid osteoma located at femoral neck. Methods Six patients with osteoid osteomas in the femoral neck received CT-guided percutaneous radiofrequency ablation. In all patients the main complaint was pain at the hip, and the course of disease varied from one month to 2 years, with an average of 8 months. Under spinal anesthesia the surgery was performed. With the help of CT guidance , a 3.5 to 4.0 mm coaxial drill system was inserted into the nidus, and an osseous access was established, then the bone biopsy needle was used to obtain specimens for pathological examination. Subsequently, a 1.5 to 2.0 cm active tip was introduced through a non-cooled radiofrequency needle into the nidus. Radiofrequency ablation was performed with the therapeutic temperature of 90℃, lasting for 6 minutes. The pain visual analogue scale (VAS) was used to evaluate the clinical effectiveness. The postoperative MRI findings were compared with the preoperative ones. Results Three days after the treatment, different degrees of pain relief was obtained in all patients, and all patients could get out of bed and walked around in one week. Postoperative VSA was significantly decreased (P<0.01). No severe complications occurred during and after the procedure. And no recurrence was seen during the follow-up period. Conclusion For the treatment of osteoid osteoma located at femoral neck, CT-guided radiofrequency ablation is a safe and effective minimally invasive treatment with fewer complications and satisfactory clinical results.