椎弓根、椎体射频热凝联合椎体成形术减轻骨转移疼痛临床研究  

Clinical research of applying pedicle and vertebral radiofrequency ablation combine with vertebral bone cement plasty technology in pat-ients with bone metastasis after conventional treatment failure

作　　者：王昆[1] 邵月娟[1] 郝建磊[1] 成宪江[1] 闫哲[1] 管冰清[1] 

机构地区：[1]天津医科大学附属肿瘤医院疼痛科天津市"肿瘤防治"重点实验室,天津300060

出　　处：《中国疼痛医学杂志》2011年第12期722-725,共4页Chinese Journal of Pain Medicine

摘　　要：目的:评价椎弓根、椎体射频热凝术(RFA)联合椎体成形术治疗骨转移患者常规治疗失败后疼痛的疗效及安全性。方法:对接受过常规治疗如放疗、化疗、内分泌治疗、止痛药物等后仍有剧烈疼痛的椎体骨转移患者,给予椎弓根、椎体RFA联合椎体成形术治疗。在影像学引导下,选择疼痛明显一侧椎弓根外侧缘为穿刺点给予射频热凝治疗,然后行转移椎体RFA联合骨水泥椎体成形术。应用VAS评分观察手术前后患者疼痛变化及药物调整情况。结果:5例患者接受了手术治疗,1例患者于术后3月死于其他部位转移。术前全部患者的VAS评分为7.40±0.99,术后第1天、1周、1月、3月、6月时VAS评分分别为3.06±0.99,3.30±0.45,2.92±0.53,3.20±0.78,2.75±0.31(与术前相比,P值均小于0.01)。患者术后4周服用止痛药物减量。术中术后未见明显并发症出现。结论:对骨转移患者常规治疗失败后可行椎弓根、椎体RFA联合椎体成形术治疗。Objective： To determine the safety and efficacy of using radiofrequency ablation（RFA） to pedicle and vertebral combine with bone cement plasty（CP） technique for bone metastases pain reduction after routine treatment failure.Methods： Pedicle and vertebral RFA combine with vertebral CP technology was applied in patients who suffered from bone metastases severe pain after conventional treatments such as radiotherapy,chemotherapy,hormone therapy and analgesic drugs.We chosed one pedicle which patient felt pain obviously as puncture point by imaging guided.Then RFA was applied to pedicle and vertebral before bone CP.Visual analogue scales（VAS） was used to measure patient pain change preoperative and postoperative,patient analgesics use was also recorded in follow-up stage.Results： A total of 5 patients received surgical treatment at last.One patient died because disease spread 3 months after treatment.VAS scores of all patients preoperative,1 day,1 week,3 months and 6 months after operation respectively were 7.40 ± 0.99,3.06 ± 0.99,3.30 ± 0.45,2.92 ± 0.53,3.20 ± 0.78 and 2.75 ± 0.31（P 0.01）.Patient analgesics use reduced significantly 4 weeks after treatment.Complications were not observed at all.Conclusion： Pedicle and vertebral RFA combine with vertebral CP technology can be used in patients with bone metastasis after conventional treatment failure.

关 键 词：射频热凝 骨水泥 椎弓根 疼痛 

分 类 号：R687.3[医药卫生—骨科学]