双平板DSA及其类CT功能在经皮椎体成形术治疗椎体转移瘤中的应用  

Clinical Application of C-arm cone beam CT Imaging and dual fluoroscopy Technique of biplane DSA in percutaneous vertebroplasty for the treatment of malignant tumor of thoracolumbar spine

作　　者：王艳伟[1] 倪才方[1] 张栋[1] 陈珑[1] 杨超[1] 

机构地区：[1]苏州大学附属第一医院介入科,江苏215006

出　　处：《当代医学》2012年第6期39-41,共3页Contemporary Medicine

基　　金：江苏省"135"工程重点人才基金(RC2003097)

摘　　要：目的研究和探讨双平板DSA及其类CT功能在经皮椎体成形术治疗椎体转移瘤术中的应用价值。方法自2009年1月～2011年7月期间,对30例脊柱恶性肿瘤患者实施经皮椎体成形术(PVP)治疗,其中15例在单球管DSA下完成(A组),15例在双平板DSA下完成(B组),通过观察术前及术后一周、一个月、三个月的VAS评分,来评价止痛效果。通过比较两组的一次性成功穿刺率、骨水渗漏率及透视时间,来评价双平板DSA及其类CT功能在经皮椎体成形术治疗椎体转移瘤中的应用价值。结果所有病例均成功完成手术,术后两组VAS评分与术前比较差异有统计学意义(P<0.05),两组间VAS评分比较无统计学意义(P>0.05)。两组间一次性成功穿刺率及透视时间比较差异有统计学意义(P<0.05)。A、B两组骨水泥渗漏的发生率分别为33.3%(5例)、20%(3例),存在显著性差异(P<0.05)。两组均无肺栓塞等严重并发症发生。结论双平板DSA及其类CT功能在经皮椎体成形术治疗椎体转移瘤中安全、临床应用价值高。Objective To explore the clinical value of C-arm cone beam CT imaging and dual fluoroscopy in percutaneous vertebroplasty （PVP） for the treatment of malignant tumor of thoracolumbar spine. Methods The 30 cases of thoracolumbar tumor were treated with PVP. All the cases were divided into two groups. Group A was performed under the single bulb DSA and Group B was under the biplane DSA. A follow-up for 3 months was accomplished. The visual analogue pain scale （VAS） was measured preoperatively and also postoperatively at 1 week, 1 month and 3 months in both groups. The rate of PMMA leakage, one-shot rate and flurouseopy time were measured in both groups. Results The rate of PMMA leakage of group A was higher than that of group B but the one-shot rate of Group A was lower than that of Group B. No statistical difference was noted in VAS of the two groups （P〉0.05）. The VAS measured preoperatively and postoperatively in two groups was proved to be significant difference （P〈0.05）. Conclusion The C-arm cone beam CT imaging and dual fluoroscopy are helpful and of clinical effectiveness in percutaneous vertebroplasty（PVP）for the treatment of malignant tumor of thoracolumbar spine.

关 键 词：椎体成形术 转移性肿瘤 双平板DSA 类CT功能 

分 类 号：R738[医药卫生—肿瘤]