CAJ | 학술논문

目的通过分析微波诱导高温灭活治疗脊柱转移肿瘤患者的手术时间、出血量、功能状态及病情转归情况，评价微波高温诱导原位灭活技术治疗后患者的预后，并为治疗方案的选择提供理论依据、数据支持。方法分析自2008~2013年间入住我院的脊柱转移肿瘤临床病例，记录每例患者的各项临床资料，于治疗前及治疗后2w、1个月、3个月、6个月、1年分别进行相应指标的监测。所有病例按治疗手段不同分为微波诱导高温原位灭活治疗(实验组)、常规手术治疗(对照组)2个治疗组。并根据Tokuhashi外科修正评分得分归为5~8、9~11、12~15分3个分数段，分别进行比较两治疗组患者术前术后各项指标。结果①9~11分、12~15分术中出血量实验组少于对照组有统计学差异(<0.05)。12~15分病例中实验组手术时间少于对照组具备统计学差异(<0.05)。②Karnofsky功能状态评分结果显示两治疗组Tokuhashi修正评分5~8分病例术后1个月，9~11分术后0.5个月、6个月，12~15分段术后0.5个月时得分实验组高于对照组并具有统计学意义。③Frankle脊髓损伤分级比较结果显示术后6个月时两治疗组间患者神经功能状态差异具有统计学意义。结论微波诱导高温原位灭活技术治疗脊柱转移瘤可以明显减少肿瘤切除过程中的出血，缩短手术时间。并且具有手术创伤小、术后恢复快、瘤灶灭活较彻底等优点。在手术治疗脊柱转移瘤方面具有明显的优势及良好的应用前景。
목적통과분석미파유도고온멸활치료척주전이종류환자적수술시간、출혈량、공능상태급병정전귀정황，평개미파고온유도원위멸활기술치료후환자적예후，병위치료방안적선택제공이론의거、수거지지。방법분석자2008~2013년간입주아원적척주전이종류림상병례，기록매례환자적각항림상자료，우치료전급치료후2w、1개월、3개월、6개월、1년분별진행상응지표적감측。소유병례안치료수단불동분위미파유도고온원위멸활치료(실험조)、상규수술치료(대조조)2개치료조。병근거Tokuhashi외과수정평분득분귀위5~8、9~11、12~15분3개분수단，분별진행비교량치료조환자술전술후각항지표。결과①9~11분、12~15분술중출혈량실험조소우대조조유통계학차이(<0.05)。12~15분병례중실험조수술시간소우대조조구비통계학차이(<0.05)。②Karnofsky공능상태평분결과현시량치료조Tokuhashi수정평분5~8분병례술후1개월，9~11분술후0.5개월、6개월，12~15분단술후0.5개월시득분실험조고우대조조병구유통계학의의。③Frankle척수손상분급비교결과현시술후6개월시량치료조간환자신경공능상태차이구유통계학의의。결론미파유도고온원위멸활기술치료척주전이류가이명현감소종류절제과정중적출혈，축단수술시간。병차구유수술창상소、술후회복쾌、류조멸활교철저등우점。재수술치료척주전이류방면구유명현적우세급량호적응용전경。
Objective To evaluate of microwave induced hyperthermia in situ inactivation treatment of patient's prognosis,and find the theory basis and data support for the options of treatment,by analyzing the microwave-induced hyperthermia inactivation treatment of spinal metastases patients with the volume of blood loss,functional status and disease outcome.Methods We have analyzed of metastatic spinal tumor clinical cases in our hospital since 2008 to 2013.Monitored the clinical data before surgery and the 0.5th month,1st month, 3rd months,6th months,12th month after surgery of each patient.Al cases are divided into two treatment groups:microwave induced hyperthermia inactivation treatment(experimental group),the conventional surgical treatment(control group),and acoording to Tokuhashi reviced surgical score,divided the cases into three scores paragraph.Then compared the informations of two treatment groups with preoperative and postoperative indicators.Results ①In Tokuhashi revised surgical score,paragraph 9~11,12~15,blood loss in the surgery of experimental group was less than the control group,( <0.05).In paragraph 12~15,operation time of the experimental group was less than the control group( <0.05);②Karnofsky performance status(Kps)results showed that, the score of the experimental group was higher than control group and had statistical significance in Tokuhashi revised score paragraph 9~11 at postoperative 0.5th months, 6th months. In paragraph 5~8 and 12~15 the Kps score of the experimental group was also higher at the 0.5th months after surgery; ③Frankle spinal cord injury scale comparison showed that, the patients' neurological status had statistical significance at the 6th months postoperation between the two treatment groups. Conclusion Microwave induced hyperthermia in situ inactivation treatment of spinal metastases may significantly reduce blood loss in the process of tumor resection, shorten the operation time.And it has the advantages of minimal y invasive, rapid postoperative recovery, metastases inactivated thoroughly. From al above,This technique has very obvious advantages and good prospects in the surgical treatment of spinal metastases.