经皮椎体成形术治疗椎体恶性病变的临床应用  

The Clinical Application of Percutaneous Vertebroplasty (PVP) for Treatment of Vertebral Malignant Lesion

作　　者：张战利[1] 张炎[2] 张俊玲[1] 卢国庆[1] 

机构地区：[1]河南省新乡市第一人民医院放射科,河南新乡453000 [2]郑州大学第一附属医院放射科

出　　处：《实用放射学杂志》2005年第2期163-165,共3页Journal of Practical Radiology

摘　　要：目的探讨经皮椎体成形术(PVP)治疗椎体恶性病变的方法及临床效果.方法对13例共15个椎体行PVP,其中椎体转移瘤11例,原发瘤2例;胸椎6例,腰椎7例,年龄45～73岁,平均59岁.在C型臂X线机或CT监视下,用11～13G、长15 cm骨穿针经椎弓根入路行椎体穿刺,穿刺成功后注入非离子型对比剂造影,了解椎体引流静脉情况,然后注入按3:2:1配制的聚甲基丙烯酸甲脂(PMMA,简称骨水泥)3～7 ml.患者随访6～12个月.结果穿刺成功率100%.76.9%(10/13)患者术后3 d内症状明显缓解,止痛效果6个月内为69.2%(9/13),1年内为54.5%(6/11).术后CT随访显示PMMA分布良好,未见椎体压缩.患者无严重并发症发生.结论PVP治疗椎体恶性病变所至疼痛、预防椎体压缩及继发性截瘫效果好,安全可行.Objective To discuss the technique and clinical efficacy of percutaneous vertebroplasty (PVP) in the treatment of vertebral malignant lesion.Methods PVP was performed in 13 patients (15 vertibrae) including metastasis in 11 and primary tumor in 2 cases,thoracic vertebrae involved in 6 cases and lumbar vertebrae involved in 7 cases.13 cases aged between 45 and 73,median age 59 years.Under C-arm fluoroscopic or CT monitoring,needle the puncture of the vertebral body was performed through the pedicle of vertebral arch using 11~13G,15 cm long needle.Omnipaque was injected into the vertebral body to understand the information of large drain veins,then 3~7 ml of polymethylmethacrylate (PMMA) bone cement mixture(with the ratio of powder/contrast agent as 3GA9552GA9551 )was injected.The patients were followed up for 6~12 months.Results The successful rate of puncture was 100%.76.9%(10/13) of patients get better in symptoms in 3 days after operation,pain relieved in 6 months was 69.2%(9/13),in one year was 54.5%(6/11).In followed up period,CT showed the PMMA distribution was good,the vertebral body had no compression,the patients had no serious complications.Conclusion PVP is an effective and safe method for malignant lesion of vertebral body in anti-pain,preventing the compression vertebral body and secondary paraplegia.

关 键 词：脊椎 椎体成行术 治疗 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学] R815[医药卫生—基础医学]