同轴活检术在经皮椎体成形术中的应用  

Percutaneous Coaxial Transpedicular Biopsy of Vertebral Body Lesions During Vertebroplasty

作　　者：葛坤元[1] 倪才方[1] 陈珑[1] 刘一之[1] 金泳海[1] 朱晓黎[1] 邹建伟[1] 

机构地区：[1]苏州大学附属第一医院介入放射科,江苏苏州215006

出　　处：《苏州大学学报（医学版）》2010年第2期301-303,340,共4页Suzhou University Journal of Medical Science

基　　金：江苏省卫生厅"135"工程重点人才基金资助项目(RC2003097)

摘　　要：目的评估同轴活检技术在经皮椎体成形术(PVP)中应用的安全性及有效性。方法 71例接受PVP患者,根据注射骨水泥前采取的活检方式不同分为未活检组(19例)、常规抽吸活检组(18例)和同轴活检组(34例)共3组。记录各组活检针被引入病变内的次数及各组骨水泥注射量;记录PVP术前、术后1周的视觉模拟划线(VAS)得分,以评估患者疼痛缓解情况;比较不同活检方法的准确率、3组患者接受PVP后的疗效以及与穿刺相关的并发症发生情况。结果 3组患者PVP术中骨水泥注射量及术后疼痛缓解情况差异无统计学意义(P>0.05)。同轴组活检针进入病灶(3.6±0.7)次,常规活检组进入病灶(2.2±0.8)次,两组差异有统计学意义(P<0.05)。同轴组34例中有30例明确诊断,另4例无明确病理诊断结果 ;常规活检组19例中12例获得明确病理诊断。两种方法活检准确率分别为88.2%和63.2%,差别有统计学意义(P<0.05)。未活检组与同轴活检组的穿刺相关并发症发生率为5.7%,常规活检组为38.9%,差异有统计学意义(P<0.05)。结论椎体成形术中行同轴活检的穿刺相关并发症少,诊断准确率高,且不影响PVP疗效。Objectives To evaluate the safety and effectiveness of percutaneous coaxial biopsy of vertebral body lesions during vertebroplasty.Methods Seventy-one patients undergone percutaneous vertebroplasty were analyzed retrospectively,and were divided into three groups,the non-biopsy group,conventional aspiration biopsy group and coaxial biopsy group,based on the biopsy methods received by them prior to the injection of bone cement.The frequency of biopsy needle being introduced into lesion and the amount of bone cement being injected were recorded.The preoperative and 1 week postoperative scores of Visual Analogue Scale were recorded for evaluation of the situation of pain relief.We compared the accuracy of different biopsy methods,efficacy of percutaneous vertebroplasty,and incidence of complications between the groups.Results There were 19 patients in the non-biopsy group,34 in coaxial biopsy group and 18 in conventional aspiration biopsy group.No difference of statistical significance in the amount of bone cement injected during operation and in pain relief after operation was found between these groups.In the coaxial biopsy group,the frequency of needle being introduced into lesion was 3.6±0.7,while it was 2.2±0.8 in the conventional aspiration biopsy group,the difference was not statistically significant.30 out of 34 patients were diagnosed definitely in the coaxial biopsy group with 4 patients lacking of definite pathological diagnosis,while 12 out of 19 patients in the conventional aspiration biopsy group were diagnosed definitely.The accuracy of the two biopsy methods was 88.2% and 63.2%,respectively.The difference of accuracy between the two groups was statistically significant.The incidence of puncture related complications in the non-biopsy group and coaxial biopsy group was 5.7%,while it was 38.9% in the conventional aspiration biopsy group,and the difference was statistically significant.Conclusions Percutaneous coaxial transpedicular biopsy of vertebral body lesions during vertebroplasty could reduce pu

关 键 词：椎体成形术 活检 同轴技术 脊柱病变 

分 类 号：R683.2[医药卫生—骨科学]