椎体血管瘤的诊断和治疗策略探讨  

Analysis of strategy for diagnosis and treatment of Vertebral Hemangioma

作　　者：罗成汉[1] 皮国富[1] 刘宏建[1] 王义生[1] 

机构地区：[1]郑州大学第一附属医院骨科,郑州450052

出　　处：《医药论坛杂志》2012年第4期51-53,56,共4页Journal of Medical Forum

摘　　要：目的探讨椎体血管瘤的诊断和治疗策略。方法郑州大学第一附属医院自2007年1月至2011年8月收治的椎体血管瘤19例,根据患者的影像学表型和临床表型以及治疗方法分为AB两组:A组为10例单纯疼痛患者,其中8例行椎体成形术,2例行放疗;B组为9例神经损害患者,行开放手术治疗。随访3～72个月,平均(30±8.4)个月,根据治疗前后及随访期间患者的临床表现,以疼痛视觉模拟评分(VAS)和日本骨科协会(JOA)评分,评定患者术后疼痛缓解及神经功能恢复情况。进行统计学分析。结果 19例患者中,10例单纯疼痛患者分别给予椎体成形术与放射治疗后疼痛均缓解;9例神经损害患者开放手术治疗患者术后神经症状部分缓解。A、B两组患者均获全程随访,术后3个月12个月及末次随访时VAS评分及JOA评分均较术前明显改善(P<0.05)。结论针对不同影像学表现及不同临床症状的椎体血管瘤选择相应的治疗策略,均可取得良好的治疗效果。Objective To explore the strategy for diagnosis and treatment of vertebral hemangioma.Methods From January 2007 to August 2011,we investigated the influencing factors of 19 cases of vertebral hemangioma（VH）,which were divided into two groups A and B.Group A： 10 cases of patients with pure pain,8 were cured by vertebroplasty and in 2 cases of the patients accepted the radiotherapy;Group B：9 cases with neural lesion symptoms were diverted to surgical treatment for symptom relief.Patients were followed up for 3 to 72 months,with an average of（30±8.4）months.The recovery of neurological function and the pain relief were measured by visual analogue scale（VAS） score and Japanese Orthopaedic Association（JOA） score.Results In all 19 cases,10 cases of patients with pure pain,8 were cured by vertebroplasty and in 2 cases of the patients accepted the radiotherapy,all of them felt pain relieved after treatment;9 cases with neural lesion symptoms received open surgery with neurological symptoms partially regained.All patients of two groups were followed up.The JOA score and VAS score had a significant recovery at 3 months,12 months and at last follow-up when compared with preoperative values（P0.05）.Conclusions For the case of vertebral hemangioma（VH）,it is necessary to combine with imaging studies,symptoms and selective surgery,in order to achieve better outcomes.

关 键 词：椎体血管瘤 治疗方法 策略 

分 类 号：R738[医药卫生—肿瘤]