PVP中“骨水泥推进器外套管”改良后在椎体骨质破坏穿刺活检中的临床应用  

The clinical application of " outer shell of bone filler device" which improved during PVP in the vertebral bone destruction biopsy

作　　者：牛宁奎[1] 王学伟[2] 施建党[1] 丁惠强[1] 师志云[3] 

机构地区：[1]宁夏医科大学总医院脊柱外科,宁夏银川750004 [2]宁夏医科大学总医院病案室,宁夏银川750004 [3]宁夏医科大学总医院医学实验中心,宁夏银川750004

出　　处：《现代肿瘤医学》2015年第24期3658-3661,共4页Journal of Modern Oncology

基　　金：宁夏自然科学基金资助项目(编号:NZ11195;NZ11275)

摘　　要：目的:评价椎体成形术(percutaneous vertebroplasty,PVP)中的骨水泥推进器外套管改良后在椎体骨破坏穿刺活检中的应用价值。方法:回顾分析30例脊柱椎体骨破坏患者,采用改良后的PVP"骨水泥推进器外套管"进行经皮穿刺活检,比较该方法的穿刺病理结果和术后病理结果。结果:30例穿刺全部获得成功,穿刺活检阳性27例,穿刺活检阳性率90.0%(27/30)。8例患者选择放化疗或放弃治疗。在行手术治疗获得大体标本病理诊断者22例,19例穿刺活检结果与最终手术病理结果相符,准确率86.4%(19/22)。其中溶骨性骨破坏12例,穿刺结果的阳性率91.7%(11/12),准确率83.3%(10/12);硬化性骨破坏7例,穿刺结果的阳性率85.7%(6/7),准确率85.7%(6/7);囊性病变3例,穿刺结果的阳性率66.7%(2/3),准确率66.7%(2/3)。恶性肿瘤总例数11例,穿刺活检敏感性81.8%(9/11),特异性90.9%(10/11)。结论:PVP中"骨水泥推进器外套管"改良后在椎体骨破坏穿刺活检中安全、阳性率高、准确率高,并可获得较多肿瘤组织,对术前诊断有较大价值。Objective ：To evaluate the clinical application of ＂ outer shell of bone filler device＂ which improved during PVP in the vertebral bone destruction biopsy. Methods ： To retrospectively analyze data of 30 cases of bone de- struction in patients with spinal vertebrae, using PVP improved after the ＂outer shell＂ in pereutaneous biopsy, biopsy results to be compared with the results of pathological process. Results：All the 30 cases of biopsy were successful ,27 cases was positive in biopsy,the biopsy positive rate was 90.0% （27/30）. 8 patients chose chemotherapy or gave up on therapy. Specimens and pathological diagnosis were obtained after the surgical treatment in 22 cases. The biopsy di- agnosis of 19 cases results were consistent with the postoperative pathological reports, and the diagnostic accuracy was 86.4% （19/22）. Among these, 12 eases biopsies were osteolytic bone destruction,the positive rate of biopsy results was 91.7% （11/12）,and the accuracy was 83.3% （10/12）. 7 cases were hardening bone destruction,the positive rate of biopsy results was 85.7% （6/7）, and the accuracy was 85.7% （6/7）. 3 cases were cystic lesions ,the positive rate of biopsy results was 66.7% （2/3）, the accuracy was 66.7 % （ 2/3 ）. The total number of malignant tumors were 11 cases, biopsy sensitivity was 81.8% （9/11 ） , and the specificity was 90.9% （ 10/11 ）. Conclusion ： Using the outer shell of bone filler device＂ which improved during PVP in the vertebral bone destruction biopsy was safe, with high positive, high accuracy, getting more tumor tissue, and especially great value in the preoperative diagnosis.

关 键 词：骨水泥推进器外套管 椎体骨破坏 穿刺活检 

分 类 号：R730.4[医药卫生—肿瘤]