CT引导下经皮穿刺氩氦刀冷冻技术对转移性骨肿瘤的临床疗效观察与研究  

Study on the clinical efficacy of CT guided percutaneous argon helium knife for the treatment of metastatic bone tumor

作　　者：赵朝阳[1] 邓少杰[1] 叶军[2] 张在恒[1] 刘文华[1] 

机构地区：[1]广东省深圳市宝安区人民医院骨外科,518101 [2]广东省东莞市长安医院骨科,523843

出　　处：《白求恩医学杂志》2016年第4期424-426,共3页Journal of Bethune Medical Science

基　　金：2013年深圳市科技计划项目(编号:201302163)

摘　　要：目的观察研究CT引导下经皮穿刺氩氦刀冷冻技术对转移性骨肿瘤的临床疗效。方法选取我院98例转移性骨肿瘤患者,回顾性分析上述患者临床治疗效果,比较患者治疗前后视觉模拟评分(VAS)及卡氏功能状态评分标准(KPS)评分变化,以及术后不良反应及并发症发生情况,总结CT引导下经皮穿刺氩氦刀冷冻技术优缺点。结果 98例转移性骨肿瘤患者,均穿刺获得满意标本,一次性成功。其中活检穿刺发现肺癌骨转移人数最多,共72例,占73.47%,其次为肝癌骨转移,共19例,占19.39%,恶性黑色素瘤7例,占7.14%。本组98例CT引导下经皮穿刺氩氦刀冷冻治疗后并发症发生率为30.06%(30/98),其中血压升高严重者为3例,占3.06%,皮肤严重冻伤者1例,占1.02%。98例患者治疗后VAS和KPS评分较治疗前有显著下降(P<0.01)。结论 CT引导下经皮穿刺氩氦刀冷冻技术不仅可以达到与常规方法治疗的准确率,且对恶性病灶的敏感度高,氩氦刀冷冻组织时定位准确,创口小,成功度较高,在保留骨诱导活性和保存肢体的前提下进行治疗。对转移性骨肿瘤患者进行CT引导下经皮穿刺氩氦刀冷冻治疗在降低局部复发率,保留骨诱导活性以及改善关节功能方面的临床应用前景广阔。Objective To observe the clinical effect of CT guided percutaneous argon helium knife in the treatment of metastatic bone tumor. Methods Ninety-eight patients with metastatic bone tumor in our hospital were analyzed retrospectively. The clinical treatment and changes of VAS and KPS score were studied. Results 98 cases of patients with metastatic bone tumor were successfully sampled. Biopsy puncture showed that the largest number of lung cancer bone metastasis is 72,accounting for 73. 47%; followed by 19 cases of bone metastasis of liver cancer,accounting for 19. 39%; 7 cases of malignant melanoma,accounting for 7. 14%. This group of 98 cases of CT guided by percutaneous argon helium cryoablation in the treatment of complication rate for 30. 06,including elevated blood pressure serious for 3 cases,accounting for 3. 06%,1 case of severe burns to the skin,1. 02%. The visual analog scale（ VAS） of 98 patients was significantly decreased compared with before treatment,aftertreatment,the KPS score decreased significantly after treatment（ P〈0. 05）. Conclusion CT guided percutaneous puncture and argon helium cryoablation can not only achieve with the accuracy of conventional treatment and malignant lesions of high sensitivity,argon helium cryoablation organization accurate positioning,smallwound,degree of success than other methods in high,retained the bone inducing activity,in the premise of keeping body treatment. The clinical application of CT guided percutaneous argon helium knife in the treatment of the patients with metastatic bone tumor under the guidance of percutaneous argon helium knife for reducing the local recurrence rate,retaining the bone inducing activity and improving the clinical application of the joint function.

关 键 词：CT引导 经皮穿刺 氩氦刀冷冻 转移性骨肿瘤 

分 类 号：R738.1[医药卫生—肿瘤]