经皮椎体后凸成形术联合射频消融术治疗脊柱转移瘤的临床疗效分析  

The Clinical Efficacy of Percutaneous Kyphoplasty Combined with Radiofrequency Ablation for Metastatic Spinal Tumors

作　　者：刘恩志[1] 郭东明[1] 严瀚[1] 钟波夫[1] 鞠洪斌[1] 

机构地区：[1]广东省广州市第一人民医院脊柱外科,广州510180

出　　处：《中国微创外科杂志》2013年第11期1031-1033,1039,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 探讨经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）联合射频消融术（radiofrequency ablation,RFA）治疗脊柱转移肿瘤的安全性与临床疗效.方法 2011年1月～2012年3月,对21例脊柱转移瘤28个椎体行PKP联合RFA治疗,采用术前、术后当天、1周视觉疼痛评分（VAS）和患者术前后服用止痛药的剂量对临床效果进行评价.结果 术后疼痛均缓解,术前VAS评分（7.5±0.5）分,术后当天VAS评分（3.0±0.5）分,术后1周VAS评分（4.0±0.5）分,术前后比较有显著性差异（F=446.67,P=0.000）.术中每个椎体填充骨水泥3.0～7.5 ml,平均4.5 ml.术后无皮肤灼伤、血管神经损伤等并发症.1例术后并发肺部感染死亡,余20例均入住肿瘤科行放疗及化疗.20例术后3个月VAS评分（4.5±0.5）分,15例术后6个月VAS评分（5.0±0.5）分.结论 PKP联合RFA对脊柱转移瘤具有良好的止痛效果,增强脊柱的稳定性.Objective To evaluate the safety and clinical efficacy of percutaneous kyphoplasty combined with radiofrequency ablation in the treatment of metastatic spinal tumors.Methods From January 2011 to March 2012,21 patients with 28 metastatic spinal tumors were managed by percutaneous kyphoplasty combined with radiofrequency ablation.We recorded VAS score before operation,on the operation day （after operation） and 1 week after operation and the oral doses of painkillers to evaluate the clinical efficacy.Results All patients were relieved of pain in post-operation period.VAS scores before operation,on the operation day （after operation） and 1 week after operation were 7.5 ± 0.5,3.0 ± 0.5 and 4.0 ± 0.5 points,respectively.There was significant difference between preoperation and postoperation in VAS scores （F =446.67,P =0.000）.Each vertebral body was filled with 3.0-7.5 ml of bone cement （average,4.5 ml）.No postoperative complications such as skins burn,vascular or nerve injury occurred.One case died of pulmonary infection after operation and the other 20 patients were transferred to department of oncology for radiotherapy and chemotherapy.The follow-up showed the VAS score of 20 patients was 4.5 ± 0.5 three months after operation,and that of 15 patients was 5.0 ± 0.5 six months after operation.Conclusion Percutaneous kyphoplasty combined with radiofrequency ablation has satisfactory effects on relieving pain caused by spinal metastases,and enhances the stability of spine.

关 键 词：经皮椎体后凸成形术 射频消融 脊柱转移瘤 骨水泥 

分 类 号：R738.1[医药卫生—肿瘤]