射频消融术联合椎体成形术在治疗脊柱转移瘤中的价值研究  

Value of radiofrequency ablation combined with percutaneous vertebroplasty in the treatment of metastatic spinal tumor

作　　者：刘成洲 贾宝欣[1] 郎军涛 邱玉金[3] 

机构地区：[1]山东省临朐县人民医院脊柱骨科,262600 [2]复旦大学附属中山医院放射科,上海 [3]潍坊医学院附属医院脊柱外科,山东潍坊261031

出　　处：《中国医师进修杂志》2017年第11期1007-1011,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 观察射频消融术（RFA）联合椎体成形术（PVP）在治疗脊柱转移瘤中的价值及临床疗效.方法 回顾性选取2013年1月至2017年1月住院的94例脊柱转移瘤患者,根据其治疗方式不同进行分组,单纯行PVP手术治疗的患者纳入PVP组（43例）;行RFA＋PVP的患者纳入RFA＋PVP组（51例）.观察两组患者术前及术后1个月的疼痛视觉模拟评分（VAS）;监测两组患者术前及术后1个月血清Ⅰ型胶原氨基末端肽（NTx）、Ⅰ型胶原羟基端肽（ICTP）和骨特异性碱性磷酸酶（BAP）的表达水平;跟踪并记录两组患者术后6个月肿瘤复发率,并比较分析.结果 PVP组患者术前VAS为（7.67±1.12）分,RFA＋PVP组为（7.71±1.04）分,两组比较差异无统计学意义（P〉0.05）;术后两组患者VAS均明显下降,PVP组降至（3.17±0.26）分,RFA＋PVP组为（2.66±0.31）分,两组患者手术前后组内比较差异有统计学意义（P〈0.05）,术后组间比较发现RFA＋PVP组VAS下降更为明显,差异有统计学意义（P〈0.05）;PVP组患者术前血清NTx、ICTP和BAP的表达水平分别为（25.39±9.77）nmol/L、（36.71±8.77）μg/L、（73.66±14.60）μg/L,术后为（19.34±6.32）nmol/L、（21.14±6.66）μg/L、（33.63±7.50）μg/L,手术前后比较差异有统计学意义（P〈0.05）;RFA＋PVP组术前血清NTx、ICTP和BAP的表达水平分别为（26.63±10.53）nmol/L、（35.37±9.42）μg/L、（75.24±13.01）μg/L,术后为（12.10±5.17）nmol/L、（15.14±5.08）μg/L、（27.19±8.22）μg/L,手术前后比较差异有统计学意义（P〈0.05）;两组患者术前组间比较差异无统计学意义（P〉0.05）,术后组间比较发现,RFA＋PVP组各组指标均显著低于PVP组,差异有统计学意义（P〈0.05）;术后6个月,RFA＋PVP组患者肿瘤复发率为3.92%（2/51）,PVP组患者肿瘤复发率为16.28%（7/43）,两组比较差异有统计学意义（P〈0.05）.结论 同单纯椎体成形术相比,RFA联合PVP可明显�Objective To evaluate the value of radiofrequency ablation （RFA） combined with percutaneous vertebroplasty （PVP） in the treatment of metastatic spinal tumor. Methods The clinical data of 94 hospitalized patients with metastatic spinal tumor from January 2013 to January 2017 were retrospectively analyzed.The patients were divided into PVP group（43 cases）and RFA＋PVP（51 cases） according to the different treatment methods. The visual analogue scores （VAS） before operation and 1 month after operation were observed.The serum levels of N-telopeptide of typeⅠcollagen（NTx）,carboxy terminal telopeptide typeⅠcollagen（ICTP）and bone alkaline phosphatase（BAP）before operation and 1 month after operation were monitored.The recurrence rate of tumor 6 months after operation was record. Results The VAS before operation in PVP group was （7.67 ± 1.12） scores, in RFA ＋ PVP group was （7.71 ± 1.04） scores, and there was no statistical difference （P〉0.05）. The VAS of 2 groups after operation was significantly lower than that before operation：PVP group（3.17 ± 0.26）scores,RFA＋PVP group （2.66 ± 0.31） scores, and there were statistical differences （P〈0.05）. The VAS in RFA ＋ PVP group was significantly lower than that in PVP group（P〈0.05）.The serum levels of NTx,ICTP and BAP before operation in PVP group were（25.39 ± 9.77）nmol/L,（36.71 ± 8.77）μg/L,（73.66 ± 14.60）μg/L;after operation were （19.34 ± 6.32） nmol/L, （21.14 ± 6.66） μg/L, （33.63 ± 7.50） μg/L, and there were statistical differences before and after operation （P〈0.05）. The serum levels of NTx, ICTP and BAP before operation in RFA＋PVP group were（26.63 ± 10.53）nmol/L,（35.37 ± 9.42）μg/L,（75.24 ± 13.01） μg/L; those after operation were （12.10 ± 5.17） nmol/L, （15.14 ± 5.08） μg/L, （27.19 ± 8.22） μg/L, and there were statistical differences before and after operation（P〈0.05）.The serum levels of NTx,ICTP and BAP after operation in

关 键 词：导管消融术 椎体成形术 脊柱 

分 类 号：R738.1[医药卫生—肿瘤]