微波消融联合经皮椎体成形术治疗椎体转移性肿瘤的疗效观察  

Microwave ablation combined with percutaneous vertebroplasty for the treatment of vertebral metastatic tumor:observation of its curative effect

作　　者：杨威 胡婷业[1] 陆玉和[1] 王凯[1] 张劲松[1] 夏磊[1] 周晓星[1] 曹惠玲[1] 张珊珊[1] YANG Wei;HU Tingye;LU Yuhe;WANG Kai;ZHANG Jingsong;XIA Lei;ZHOU Xiaoxing;CAO Huiling;ZHANG Shanshan(Department of Vascular Intervention,Chuzhou Municipal First People's Hospital,Affiliated Chuzhou Clinical College of Anhui Medical University,Chuzhou,Anhui Province 239000,China)

机构地区：[1]安徽医科大学附属滁州临床学院(滁州市第一人民医院)介入血管科,安徽滁州239000

出　　处：《介入放射学杂志》2020年第11期1146-1150,共5页Journal of Interventional Radiology

基　　金：安徽省滁州市重点研究开发项目(农村与社会发展领域)(2018ZN010)。

摘　　要：目的探讨微波消融(MWA)联合经皮椎体成形术(PVP)治疗椎体转移性肿瘤引起疼痛的临床疗效。方法入住椎体转移性肿瘤患者80例,随机分为研究组和对照组各40例,对照组采用PVP术,研究组采用MWA联合PVP术治疗,观察并记录两组患者术前、术后3 d、术后1周、术后1个月、术后3个月和术后6个月疼痛视觉模拟评分(VAS),镇痛药物使用评分(AUS)和肿瘤患者生活质量评分(QLS),分析患者疼痛症状缓解情况,同时比较两组患者骨水泥注入量、渗漏节数、X线曝光时间和手术费用。结果80例患者手术均成功,两组患者术前、术后3 d、术后1周、术后1个月、术后3个月VAS、AUS和QLS比较差异无统计学意义(P>0.05),骨水泥注入量、渗漏节数、X线曝光时间比较差异无统计学意义(P>0.05),术后6个月VAS、AUS和QLS比较差异有统计学意义MWA联合PVP组较对照组为优(P<0.05),同组患者手术前后比较差异有统计学意义(P<0.05),手术费用比较差异有统计学意义(P<0.05)。结论MWA联合PVP术治疗椎体转移性肿瘤,能有效缓解患者的疼痛,减少镇痛药物的使用,提高患者的生活质量,但手术费用偏高。Objective To investigate the clinical efficacy of microwave ablation(MWA)combined with percutaneous vertebroplasty(PVP)for the treatment of pain caused by vertebral metastatic tumor.Methods A total of 80 patients with vertebral metastatic tumor,who were admitted to Chuzhou Municipal First People’s Hospital of China,were randomly and equally divided into the study group(n=40)and the control group(n=40).The patients of the control group were treated with PVP,while the patients of the study group were treated with MWA combined with PVP.In all patients of both groups,the visual analogue scale(VAS)scores of pain,the analgesic use score(AUS)and the quality of life score(QLS)were recorded before treatment as well as at 3 days,one week,one month,3 months and 6 months after treatment,and the degree of pain relief was analyzed.The used amount of bone cement,the number of vertebral segments showing cement leakage,the intraoperative X-ray exposure time and the operation cost were compared between the two groups.Results Successful operation was accomplished in all the 80 patients.There were no significant differences in VAS,AUS and QLS determined before treatment as well as at 3 days,one week,one month and 3 months after treatment between the two groups(P>0.05).No statistically significant differences in the used amount of bone cement,the number of vertebral segments showing cement leakage,the intraoperative X-ray exposure time existed between the two groups(P>0.05).The postoperative 6-month VAS,AUS and QLS in the study group were significantly better than those in the control group(P<0.05).In the same group,the preoperative VAS,AUS and QLS were significantly different from the postoperative ones in both groups(P<0.05).Statistically significant difference in operation cost existed between the two groups(P<0.05).Conclusion For the treatment of vertebral metastatic tumor,MWA combined with PVP can effectively alleviate vertebral body pain,reduce the use of analgesics and improve the quality of life of patients,however,the oper

关 键 词：椎体 转移性肿瘤 微波消融 经皮椎体成形术 疼痛 

分 类 号：R543.1[医药卫生—心血管疾病]