iGuide虚拟导航辅助C臂CT引导下125I粒子植入术治疗溶骨性骨转移癌所致疼痛  

iGuide virtual navigation-assisted C-arm CT-guided ^(125)I seed implantation for treating the pain caused by osteolytic bone metastases

作　　者：刘一铭 许凯豪 焦德超[1] 韩新巍[1] 马波[1] 徐苗[1] 贾自玲 LIU Yiming;XU Kaihao;JIAO Dechao;HAN Xinwei;MA Bo;XU Miao;JIA Ziling(Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院放射介入科,河南郑州450052

出　　处：《中国介入影像与治疗学》2022年第3期143-147,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察iGuide虚拟导航辅助C臂CT引导下经皮穿刺^(125)I粒子植入术治疗溶骨性骨转移癌所致疼痛的效果。方法回顾性分析86例115处溶骨性骨转移癌引发疼痛患者,经常规治疗后疼痛无缓解或拒绝常规治疗,接受iGuide虚拟导航辅助C臂CT引导下经皮穿刺^(125)I粒子植入术。记录技术成功率、手术并发症、90%体积肿瘤吸收剂量(D90),比较术前及术后1、4、8周患者每日吗啡摄入量(DMC)和视觉模拟量表(VAS)评分,以及术前与术后8周Karnofsky评分。结果^(125)I粒子植入术技术成功率100%;D90为93.56~142.46 Gy,平均(110.54±3.41)Gy。术前DMC及VAS评分分别为(86.28±22.18)mg及(6.40±0.96)分,术后1周降至(54.88±12.05)mg及(4.48±0.76)分,之后逐渐下降,至术后8周降为(23.14±7.07)mg及(1.86±0.65)分(P均<0.05);Karnofsky评分由术前的(74.19±7.27)分升高至术后8周(88.37±6.66)分(P<0.05)。主要和次要并发症发生率分别为2.33%(2/86)和11.63%(10/86)。结论iGuide虚拟导航辅助C臂CT引导下经皮穿刺^(125)I粒子植入术可有效缓解溶骨性骨转移癌所致疼痛,且安全性高。Objective To observe the effect of iGuide virtual navigation-assisted C-arm CT-guided percutaneous puncture ^(125)I seed implantation for treating the pain caused by osteolytic bone metastases.Methods Eighty-six patients with 115 osteolytic bone metastases who had pain not relief after conventional treatment or refused conventional treatment underwent iGuide virtual navigation-assisted C-arm CT-guided percutaneous puncture ^(125)I seed implantation.The technical success rate,complications and 90%volume tumor absorbed dose(D90)were recorded.The daily morphine consumption(DMC)and visual analogue scale(VAS)score of patients were compared before and 1,4 and 8 weeks after implantation,while Karnofsky scores were compared before and 8 weeks after implantation.Results The technical success rate of ^(125)I seed implantation was 100%.D90 ranged from 93.56 to 142.46 Gy,with an average of(110.54±3.41)Gy.DMC and VAS scores before implantation was(86.28±22.18)mg and(6.40±0.96)points,respectively,decreased to(54.88±12.05)mg and(4.48±0.76)points 1 week after implantation,respectively,which kept decreased to(23.14±7.07)mg and(1.86±0.65)points 8 weeks after implantation(all P<0.05).Meanwhile,Karnofsky score increased from(74.19±7.27)points before to(88.37±6.66)points 8 weeks after implantation(P<0.05).The incidence of major and minor complications of operation was 2.33%(2/86)and 11.63%(10/86),respectively.Conclusion iGuide virtual navigation-assisted C-arm CT-guided percutaneous puncture ^(125)I seed implantation could effectively relieve the pain caused by osteolytic bone metastases with high safety.

关 键 词：转移性骨肿瘤 癌性疼痛 放射治疗 碘放射性同位素 虚拟导航 C臂CT 

分 类 号：R738.1[医药卫生—肿瘤] R815[医药卫生—临床医学]