CT引导下经皮椎体成形术治疗椎体血管瘤  

Vertebral hemangiomas treated with the CT-guided percutaneous vertebroplasty

作　　者：张卓[1] 刘涛[1] 李永军[1] 

机构地区：[1]冀中能源峰峰集团有限公司总医院南院区CT科,河北邯郸056200

出　　处：《中国医师进修杂志》2012年第23期23-25,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨CT引导下经皮椎体成形术治疗椎体血管瘤的价值。方法CT引导下对42例症状性椎体血管瘤患者的49个病变椎体行经皮穿刺后进人椎体并注入骨水泥。术前和术后不同时间段分别采用视觉模拟评分法（VAS）评分、活动能力评分、使用止痛药物评分及远期综合疗效WHO标准评价，并对结果进行统计学分析。结果42例患者（49个病变椎体）手术成功率为100．0％（42／42），无严重并发症。术后随访6～18（12．50±1．15）个月，所有病变椎体影像学检查均未见肿瘤复发和椎体塌陷。VAS评分由术前的（7．64±1．29）分降至术后1～3d的（4．82±1．21）分和术后3～6个月的（0．22±0．19）分（P〈0．05）；活动能力评分由术前的（3．4±0．9）分降至术后1。3d的（2．1±0．6）分和术后3～6个月的（1．0±0．3）分（P〈0．05）；使用止痛药物评分由术前的（1．9±0．6）分降至术后1～3d的（1．1±0．2）分和术后3～6个月的（0．2±0．1）分（P〈0．05）。术后远期综合疗效WHO标准评价：有效率为97．6％（41／42）。结论CT引导下经皮椎体成形术可有效缓解椎体血管瘤引起的疼痛，增加椎体的稳定性，改善运动功能，是一种安全、微创、有效的治疗方法，并且较C型臂X线机引导更具优势。Objective To discuss the value of vertebral hemangiomas treated with the CT-guided percutaneous vertebroplasty （PVP）. Methods Forty-two patients with 49 vertebral lesions were guided by CT and injected with bone cement percutaneous into the vertebral. The effectiveness was valued by preoperative and postoperative visual analogue scale （VAS）,locomotor activity scores, pain medication scores and comprehensive evaluation of long-term efficacy of WHO criteria, and undertook statistical analysis. Results The success rate in all patients was 100.0%（42/42）, no serious complications. All the patients were followed up for 6 - 18 （ 12.50 ± 1.15 ） months, all lesions of the vertebral body imaging showed no tumor recurrence and vertebral collapse. The VAS scores decreased from preoperative （7.64 _± 1.29） scores to postoperative 1-3 days （4.82 ± 1.21） scores and to postoperative 3 -6 months （0.22 ±0.19） scores （P〈0.05）. The locomotor activity scores decreased from preoperative （3.4 ± 0.9） scores to postoperative 1-3 days （2.1 ± 0.6） scores and to postoperative 3-6 months （1.0 ± 0.3） scores （P 〈 0.05）. The pain medication scores decreased from preoperative （ 1.9 ± 0.6） scores to postoperative 1 - 3 days months （ 1.1 ± 0.2） scores and to postoperative 3-6 months （0.2 ± 0.1 ） scores （P 〈 0.05 ）. Comprehensive evaluation of long-term efficacy of WHO criteria：efficiency rate was 97.6% （41/42）. Conclusions CT-guided percutaneons vertebroplasty for vertebral hemangioma can effectively relieve the pain caused by vertebral body to increase stability, improve motor function,which is a method with safe, minimally invasion, effect, and is superior than C-arm fluoroscopy.

关 键 词：脊柱融合术 血管瘤 体层摄影术 X线计算机 

分 类 号：R687.3[医药卫生—骨科学]