CT引导下骨水泥灌注治疗髂骨转移瘤  

CT-guided bone cement infusion for metastatic tumor to the ilium

作　　者：宋蓬威 于杨 刘明镇[3] 刘训伟[3] 王志国[3] 谢志勇[3] 

机构地区：[1]威海卫人民医院影像科,山东省威海市264200 [2]成武县人民医院胸外科,山东省成武县274200 [3]济南军区总医院医学影像科,山东省济南市250031

出　　处：《中国组织工程研究》2017年第27期4379-4384,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家高技术研究发展计划(863计划)资助(2013AA032203);国家自然科学基金资助(81671799)~~

摘　　要：背景:髂骨是骨转移瘤较常见发病部位,易穿破皮质并形成软组织肿块。髂骨形态不规则,周围结构复杂,在行骨水泥灌注时存在穿刺困难和骨水泥弥散情况难以判定等问题。目的:比较CT引导和DSA引导下穿刺并行骨水泥灌注治疗髂骨转移瘤的临床疗效。方法:64例患者行髂骨骨水泥灌注治疗,按治疗方案分为2组,对照组32例应用DSA监视下穿刺灌注骨水泥,实验组32例应用CT引导穿刺,术后行CT扫描观察骨水泥弥散情况。统计并比较分析2组患者一次性穿刺成功率、骨水泥的渗漏率、疼痛目测类比评分、Oswestry功能障碍指数。结果与结论:①2组患者均顺利完成穿刺并骨水泥灌注,DSA引导组骨水泥外溢2例,CT引导组骨水泥外溢1例;②2组患者治疗后的疼痛目测类比评分、Oswestry功能障碍指数均较治疗前改善(P<0.05),2组组间比较差异无显著性意义(P>0.05);③2种方法缓解疼痛和恢复活动的效果无差异;④结果表明,在注意骨水泥灌注时机后,CT引导下治疗髂骨转移瘤可取得满意的效果。BACKGROUND： Iliac bones are common habitant parts in metastatic tumor of bone, and the affiliate cortex is easy to be penetrated into soft tissue blots. The irregular iliac shape and its complex surrounding tissues create the difficulties in puncture operations and cement perfusion.OBJECTIVE： To investigate the clinical outcomes of CT-guided versus DSA-guided puncture combined with bone cement perfusion for metastatic tumor to the ilium.METHODS： Sixty-four patients with metastatic tumor to the ilium udergoing bone cement perfusion were enrolled, and then divided into control and experimental groups （n=32 per group）, followed by treated with DSA-guided percutaneous injection of bone cement, and CT-guided puncture, respectively. Subsequently, the diffuse distribution of bone cement was observed using CT. The success rate, leakage rate, Visual Analogue Scale scores and Oswestry Disability Index were compared between two groups.RESULTS AND CONCLUSION： （1） All patients received the surgery successfully, and bone cement leakage happened in two cases of control group and one case of experimental group. （1） The Visual Analog Scale and Oswestry Disability Index scores in the two groups were significantly better than those before treatment （P 0.05）. （3） No difference was found in the pain relief and functional recovery between two groups. （4） To conclude, CT-guided treatment can achieve satisfactory outcomes for metastatic tumor to the ilium by bone cement infusion in appropriate time.

关 键 词：骨科植入物 骨植入物 肿瘤 骨转移 溶骨性 穿刺 经皮骨成形术 

分 类 号：R318[医药卫生—生物医学工程]