射频消融姑息性治疗骨转移瘤的效果(附8例报告)  

CT-guided percutaneous radiofrequency ablation of bone metastases:a case report of 8 patients

作　　者：郑龙坡[1] 蔡郑东[1] 张治宇[1] 李全[1] 汝鸣[1] 高博[1] 李健[1] 梁文清[1] 

机构地区：[1]第二军医大学附属长海医院骨科,上海200433

出　　处：《中国骨肿瘤骨病》2009年第2期87-90,共4页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的探讨射频消融用于临床姑息性治疗骨转移瘤的可行性及临床疗效。方法2005年2月至2008年2月应用射频消融于8例骨转移瘤患者15处病灶。男6例,女2例;年龄37～72岁,平均47.4岁。随访3～18个月,平均6.5个月。手术前后行MR病灶扫描,进行影像学对比。疼痛视觉类比评分法(visual analoguescore,VAS)作为临床疗效评定指标。结果术后3～7d内因肿瘤引起的疼痛症状明显缓解,3个月内随访无明显变化。VAS评分明显降低,术前7.38±1.41,术后7 d2.75±0.79,3个月时2.25±0.21,术前后差异有统计学意义(P<0.05)。术后8例患者病理结果证实为骨转移瘤。术中、术后无严重并发症,末次随访局部肿瘤无复发。术后3个月复查MR T2加权像总显效率93.3%。结论CT引导下经皮穿刺射频消融技术姑息性治疗骨转移瘤是安全、有效、可行的,可选择作为治疗骨转移病灶疼痛的一种方法。Objective To discuss and evaluate the clinical effect of the treatment for bone metastases by CT- guided percutaneous radiofrequency ablation （RFA）. Methods From February 2005 to February 2008, 8 patients with 15 diseased regions, with the diagnosis of bone metastases were included in the study. There were 6 males and 2 females with an average age of 47.4 years （ranging from 37 to 72 ）. The follow-up is 18 to 24 months, with an average of 19.5 months. The preoperative and postoperative MRI scans were compared. And the pain visual analog score （VAS） was used as an evaluation parameter for measuring clinical effect. Results All procedures were technically successful. No major complications occurred. No recurrence was observed at the end of the follow-up period. All patients＇ pain was released significantly 3 days to one week after surgery, and disappeared 3 month after after surfery. Biopsy outcomes were positive in all patients. Postoperative MRI T2-weighted signal reduction for different patients varied. The effective rate in 3 months aftersurgery is 93.3%. VAS score decreased sharply, which is of significant statistical value （P〈0.01）. Conclusions CT-guided percutaneous RFA is a safe, effective and feasible method of palliative treatment for bone metastases. RFA can be chosen as a reliable method in clinical treatment for bone metastases.

关 键 词：骨转移 外科治疗 射频 消融术 穿刺术 

分 类 号：R738.1[医药卫生—肿瘤]