经皮骨成形术治疗92例肺癌椎体外骨转移患者的临床观察  

Clinical observation of percutaneous osteoplasty in the treatment of 92 lung cancer patients with extraspinal bone metastases

作　　者：王智煜[1] 宁琳琳[1] 李洪涛[1] 杨玉梅[1] 吴春根[2] 赵晖[1] 姚阳[1] 

机构地区：[1]上海市第六人民医院肿瘤内科,上海200233 [2]上海市第六人民医院放射介入科,上海200233

出　　处：《肿瘤》2014年第5期443-449,共7页Tumor

基　　金：国家自然科学基金资助项目(编号:81201628)

摘　　要：目的 :探讨经皮骨成形术治疗肺癌椎体外骨转移患者的安全性和临床疗效。方法 :2008年6月—2012年12月,92例肺癌椎体外骨转移患者接受经皮骨成形术。于术前24 h以及术后24 h、1个月、3个月和6个月时,采用视觉模拟评分评定患者疼痛缓解情况,采用Karnofsky体能状况评分和活动能力评分评定患者生活质量改善情况。对于骨盆转移患者,采用Harris髋关节评分评定髋关节功能恢复情况;对于四肢转移患者,采用Mirels评分评定四肢骨折风险改善情况。结果 :92例患者均顺利完成手术,手术成功率为100%,未发生严重并发症。术后患者的疼痛、生活质量、活动能力和髋关节活动功能均有明显改善,四肢骨折风险有所下降,其中术前24 h与术后1个月和3个月时的各类相关评分的差异均有统计学意义(P<0.05)。结论 :经皮骨成形术治疗肺癌骨转移患者的手术创伤较小,可以明显缓解患者的疼痛,提高患者的生存质量,值得在临床上推广应用,但应注意选择合适的患者及手术时机。Objective： To assess the security and clinical efficacy of percutaneous osteoplasty （POP） in the treatment of lung cancer patients with extraspinal bone metastases. Methods： Between June 2008 and December 2012, 92 lung cancer patients with extraspinal bone metastases underwent POP. The scores of visual analogue scale, mobility scale, Karnofsky performance status, Harris hip scale and Mirels scale were evaluated 24 h before POP and 24 h, 1 month, 3 months and 6 months after POP. Results： Ninety-two patients were all successfully operated with no serious clinical complications. After POP, the scores of visual analogue scale, mobility scale, Karnofsky performance status and Harris hip scale were improved, and the risk of limb fractures was decreased, with a statistically significant difference between 24 h before POP and 1 month and 3 months after POP （P 〈 0.05）. Conclusion： POP is a minimally invasive operative procedure, which can significantly relieve the pain and improve the quality of life, and is worthy of clinical application, but the appropriate patients and the timing of operation should be considered.

关 键 词：肺肿瘤 椎体外骨转移 经皮骨成形术 视觉模拟评分 活动能力评分 

分 类 号：R738.1[医药卫生—肿瘤]