脊神经射频热凝术治疗成骨性椎体转移瘤并发神经痛的近期疗效  

Short-term efficacy of spinal nerve radiofrequency thermocoagulation for osteogenic vertebral metastatic tumor complicated with neuralgia

作　　者：康新国[1] 孙青 段自坤 叶生丽 贺纯静[1] Kang Xinguo;Sun Qing;Duan Zikun;Ye Shengli;He Chunjing(Department of Pain,Guizhou Provincial People’s Hospital,Guiyang 520002,Guizhou,China)

机构地区：[1]贵州省人民医院疼痛科,贵阳520002

出　　处：《脊柱外科杂志》2023年第5期301-305,共5页Journal of Spinal Surgery

基　　金：贵州省人民医院青年基金项目[GZSYQN(2019)14号]。

摘　　要：目的探讨脊神经射频热凝术治疗成骨性椎体转移瘤并发神经痛的近期疗效。方法回顾性分析2017年10月—2021年5月收治的63例胸腰椎成骨性椎体转移瘤患者的临床资料,所有患者均在药物治疗基础上行脊神经后内侧支射频热凝术治疗。记录手术前后患者镇痛药物服用情况。术前及术后1 d、7 d、1个月采用疼痛视觉模拟量表(VAS)评分、Karnofsky功能状态(KPS)评分评估患者疼痛程度及功能状态。结果所有患者顺利完成治疗,术后1 d、7 d、1个月的VAS评分较术前明显降低,KPS评分较术前明显升高,差异均有统计学意义(P<0.05)。患者术后口服镇痛药物剂量较术前明显降低,差异有统计学意义(P<0.05)。患者术后临床疗效评价优20例、有效30例、无效13例,总有效率为79.4%。结论脊神经射频热凝术可有效控制成骨性椎体转移瘤导致的神经痛,提高患者生活质量,减少阿片类药物的使用剂量。Objective To investigate the short-term effect of radiofrequency thermocoagulation of spinal nerve in the treatment of osteogenic vertebral metastatic tumor with neuralgia.Methods The clinical data of 63 patients with thoracolumbar osteogenic vertebral metastatic tumor admitted from October 2017 to May 2021 were retrospectively analyzed.All the patients were treated with radiofrequency thermocoagulation on the posterior medial branch of spinal nerve on the basis of drug therapy.The administration of analgesics before and after the operation was recorded.The pain intensity and functional status of the patients were evaluated by the visual analogue scale of pain(VAS)score and Karnofsky functional status(KPS)score at pre-operation and postoperative 1 d,7 d and 1 month.Results All the patients successfully completed the treatment,VAS score at postoperative1 d,7 d and 1 month was significantly lower than that before surgery,and KPS score was significantly higher than that before surgery,the differences were statistically significant(P<0.05).The doses of oral analgesicdrugsin after surgery were significantly reduced compared with those before surgery,with a statistical significance(P<0.05).The postoperative clinical efficacy,excellent in 20 cases,effective in 30,and ineffective in 13,with an overall effective rate of 79.4%.Conclusion Radiofrequency thermocoagulation of spinal nerve can effectively control the neuralgia caused by osteogenic vertebral metastatic,tumor improve the patients’life quality,and reduce the dosage of opioids.

关 键 词：胸椎 腰椎 肿瘤转移 外科手术 微创性 

分 类 号：R681.533[医药卫生—骨科学]