3-D移动X线机引导下PVP治疗脊柱恶性肿瘤的临床研究  

Clinical study of 3-D X-ray guided percutaneous vertebroplasty for the spinal malignant tumors

作　　者：孙远新[1] 史峰军[1] 崔明宇[1] 

机构地区：[1]大庆油田总医院脊柱外科,黑龙江大庆163000

出　　处：《哈尔滨医科大学学报》2013年第1期88-90,93,共4页Journal of Harbin Medical University

摘　　要：目的通过3-D移动X线机引导下经皮穿刺椎体成形术(PVP)治疗脊椎原发及转移瘤,分析与疗效的相关因素,提高治疗技术。方法回顾性分析57例脊椎原发性肿瘤及转移瘤患者在3-D移动X线机引导下行经皮穿刺椎体成形术的效果和并发症。57例患者69节椎体病变,经病史、影像学及术中病理证实椎体肿瘤行PVP术,术中经3-D移动X线机引导下注入聚甲基丙烯酸甲酯(PMMA)颈椎1.5～2.5 mL,胸椎为2～4 mL,腰椎为2～6 mL。结果术后显示疼痛完全缓解73.9%,部分缓解20.9%,总有效率94.8%。术后影像证实椎体周围组织渗漏5例,1例椎管内硬膜囊外和1例渗漏入椎间盘。结论经3-D移动X线机下引导行PVP治疗脊柱肿瘤,通过3-D成像,穿刺定位准确,骨水泥注入量容易控制,疼痛缓解明显,临床效果确切。Objective To evaluate the safety and efficacy of percutaneous vertebroplasty （PVP） under 3-D X-ray for the treatment of vertebral malignant tumors in order to improve the therapeutic technique. Methods PVP was performed under the guidance of 3-D X-ray fluoros- copy in 57 consecutive patients with 69 vertebral malignant tumors verified by the history ima- ging and pathology. The cement injected into vertebrae were 1.5 -6 mL respectively. Among them, pain was improvement before the procedure. Results The total rate of pain relief reached 94. 8%. The success rate of technique reached 95.7%. Contrast material injection af- ter the needle placement within the vertebral body was undertaken in 69 vertebras. As a result, leakage were seen injecting PMMA cement under 3-D X-ray respectively. There were 5 para- vertebral leaks, including 1 epidural and 1 intervertebral leaks detected by 3-D X-ray scan. Conclusion 3-D X-ray guided percutaneous vertebroplasty for the spinal malignant tumors can povide accurate puncture positioning, easy control PMMA, and significant pain relief, and can be performed safely and effectively.

关 键 词：3-D移动X线机 脊柱恶性肿瘤 经皮穿刺椎体成形术 

分 类 号：R816.8[医药卫生—放射医学]