多点穿刺经皮骨强化术治疗髋关节溶骨转移  

Multi-point puncture percutaneous bone augmentation for treating osteolytic metastasis of hip

作　　者：刘明镇 李娟 邱思强[2] 刘训伟 郝润松[2] LIU Ming-zhen;LI Juan;QIU Si-qiang;LIU Xun-wei;HARun-song(Department of Medical Imaging,960 Hospital of PLA,Shandong 250031,China)

机构地区：[1]解放军联勤保障部队第960医院放射诊断科,山东济南250031 [2]山东第一医科大学第三附属医院(济南市第四人民医院),山东济南250031

出　　处：《影像诊断与介入放射学》2021年第4期277-281,共5页Diagnostic Imaging & Interventional Radiology

基　　金：国家自然科学基金(81671799)。

摘　　要：目的探讨多点穿刺经皮骨强化术(PBA)治疗累及髋关节的溶骨性转移的手术方法及疗效。方法回顾性分析了行多点穿刺PBA治疗累及髋关节的溶骨性转移8例患者,男女各4例,平均年龄(55.0±10.1)岁,采用术前、术后视觉模拟评分(VAS)、Harris髋关节功能评分以及影像学评价结果评估疗效和髋关节功能。应用SPSS Statistics 19统计软件,使用配对t检验、方差分析和卡方检验对所得数据进行统计学分析。结果所有患者均顺利完成手术,术前、术后7 d、1个月、3个月VAS评分分别为8.13±0.99、2.38±0.92、2.13±0.99、2.50±1.07,术后7 d、1个月、3个月VAS评分较术前均有下降(P<0.05),术后各时间点无明显统计学差异(P>0.05);Harris髋关节功能评分术前、术后7 d、1个月、3个月分别为38.00±18.06、75.50±11.50、77.75±10.29、76.00±11.53,术后7 d、1个月、3个月Harris髋关节功能评分较术前均有明显升高(P<0.05),术后各时间点无明显统计学差异(P>0.05);术后1个月、3个月未出现骨水泥块游离及移位情况,软组织肿块5例部分缓解(PR)、3例稳定(SD)。结论多点穿刺PBA治疗累及髋关节的溶骨性转移,手术安全创伤小,可缓解疼痛,改善髋关节功能,提高患者生存质量。Objective To explore the effect of multi-point puncture of percutaneous bone augmentation in the treatment of osteolytic metastasis of the hip.Methods 8 patients(4 men,4 women;mean age:55.0±10.1 years)underwent multi-point puncture of percutaneous bone augmentation for treating osteolytic metastasis involving the articular surface of the acetabulum.Preoperative and postoperative visual analogue scale(VAS),Harris hip joint scores,and imaging evaluation were used to evaluate retrospectively the clinical efficacy and hip joint function.SPSS statistics 19.0 software was used to analyze the data by paired t test,ANOVA andχ^(2) test.Results The treatment was completed successfully on all patients.The preoperative VAS score decreased significantly(P<0.05)from 8.13±0.99 to 2.38±0.92 at 7 days,2.13±0.99 at 1 month,and 2.50±1.07 at 3 months after the procedure whereas there was no statistically significant difference at each time point post treatment(P>0.05).The preoperative Harris hip scores increased significantly(P<0.05)from 38.00±18.06 to 75.50±11.50 at 7 days,77.75±10.29 at 1 month,and 76.00±11.53 at 3 months after the procedure whereas there was no significant difference at each time point post treatment(P>0.05).There was no bone cement block dissociation and position change at 1 month and 3 months post treatment with partial remission(5)and stable disease(3)for the soft tissue mass.Conclusion Multi-point percutaneous bone augmentation in the treatment of osteolytic metastases involving the hip joint is safe and minimally invasive.It can relieve pain,improve hip function and improve the quality of life.

关 键 词：骨转移瘤 经皮骨强化术 视觉模拟评分 Harris髋关节功能评分 

分 类 号：R738.1[医药卫生—肿瘤] R687.3[医药卫生—临床医学]