运用高黏度骨水泥治疗脊柱转移瘤的临床观察  

The clinical effect research of high viscosity bone cement treatment of vertebral metastasis tumor

作　　者：何齐芳[1] 

机构地区：[1]浙江省杭州市第一人民医院骨科,310006

出　　处：《中华全科医学》2015年第5期759-760,818,共3页Chinese Journal of General Practice

摘　　要：目的考察在脊柱转移瘤患者经皮椎体成形术(PVP)中采用高黏度骨水泥的临床效果,并与应用低黏度骨水泥的临床效果作比较。方法选择2012年6月—2013年8月收住杭州市第一人民医院骨外科行PVP手术的脊柱转移瘤患者28例,随机分为治疗组(16例)和对照组(12例),治疗组在手术中给予高黏度骨水泥,对照组给予低黏度骨水泥。结果全部28例患者均顺利完成手术。2组患者在手术时间、手术情况等方面差异无统计学意义(P>0.05)。治疗1周时,2组患者疼痛症状均较治疗前明显减轻(P<0.05),治疗3个月后,治疗组疼痛症状改善、脊柱功能评分的改善均较对照组更为显著(分别是P=0.0283,P<0.001);治疗组患者止痛药的使用等级下降(P<0.05),与对照组比较差异也具有统计学意义(P<0.05)。治疗组手术并发症更少,与对照组比较差异有统计学意义[分别是治疗组有2例(12.5%)渗漏,对照组有4例(33.3%)渗漏,1例(8.3%)肺栓塞,2例(16.7%)毒性反应和1例(8.3%)邻椎骨折]。结论在脊柱转移瘤患者经皮椎体成形术(PVP)中采用高黏度骨水泥,较低粘度骨水泥具有更好的临床效果,患者的疼痛症状和脊柱功能评分得到良好的改善,且手术并发症更少,推荐在临床合理应用。Objective To explore the clinical effect of high viscosity bone cement treatment in patients with spinal metastases of percutaneous vertebroplasty（ PVP）. Methods 28 patients with vertebral metastasis tumor underwent PVP operation in Hangzhou First People＇s Hospital from June 2012 to August 2013 were randomly divided into the experimental group（ 16 patients） and control group（ 12 patients）. High viscosity bone cement was used for the treatment group,and the low viscosity bone cement was used for the control group. Results All 28 patients were successfully completed surgery.The two groups had no significant difference in operation time and other aspects of operation（ P〉0. 05）. After 1 week of treatment,pain symptoms in two groups was significantly reduced than the before of treatment（ P〈0. 05）,and after 3 months of treatment,the pain symptom improvement and spinal function scores in the treatment group were significant lower than those in the control（ P = 0. 0283,P〈0. 001）; the analgesics levels in the treatment group was much lower comparing to the control group（ P〈0. 05）,and complications of operative was lesser than those in the control group with statistical significance[In treatment group leakage was 2 cases（ 12. 5%）,and leakage was 4 cases（ 33. 3%） pulmonary embolism was 1 cases（ 8. 3%）,toxicity reaction was 2 cases（ 16. 7%） and 1 cases of adjacent vertebral fractures（ 8. 3%） in the control group separately]. Conclusion In patients of spinal metastatic tumor with percutaneous vertebroplasty（ PVP）,using high viscosity bone cement had better clinical effect than with low viscosity bone cement,and gained more better improved in pain symptoms and spinal function score,with less operation complications. We recommend it to be applied reasonably in clinic.

关 键 词：高黏度骨水泥 脊柱转移瘤 经皮椎体成形术(PVP) 

分 类 号：R738.1[医药卫生—肿瘤]