C臂CT引导下微波消融联合经皮骨成形术治疗四肢骨转移瘤的临床疗效  

Clinical efficacy of C-arm CT-guided microwave ablation combined with percutaneous osteoplasty in the treatment of extremity bone metastases

作　　者：林志鹏 陈都 胡小龙 黄大钡[1] 邹旭公 陈源[1] 张健[1] 李晓群[1] LIN Zhipeng;CHEN Du;HU Xiaolong;HUANG Dabei;ZOU Xugong;CHEN Yuan;ZHANG Jian;LI Xiaoqun(Department of Interventonal Medicine,Zhongshan People's Hospital,Guangdong Zhongshan 528400,China.)

机构地区：[1]中山市人民医院介入医学科,广东中山528400

出　　处：《现代肿瘤医学》2024年第19期3743-3747,共5页Journal of Modern Oncology

摘　　要：目的:评估C臂CT引导下微波消融联合骨成形术治疗四肢骨骨转移瘤的安全性、有效性。方法:回顾性收集2016年01月至2023年01月我院行微波消融联合骨成形术治疗顽固性疼痛引起的四肢骨骨转移瘤53例,治疗前后定期评价视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、生活质量评价表(QOL)的变化及观察术后并发症。结果:手术成功率100%。术前、术后1天、1周、1个月、3个月、6个月VAS评分分别为7.6±1.1、7.7±0.9、2.4±1.0、1.7±0.7、1.6±1.1、2.3±1.3;患者手术前后VAS变化有统计学意义(F=143.4,P<0.001);ODI评分分别为46.8±1.8、45.4±2.0、18.3±2.8、16.7±2.6、18.0±4.5、24.7±1.8;患者手术前后ODI变化有统计学意义(F=91.8,P<0.001);QOL评分分别为24.5±3.8、25.8±2.4、38.8±2.7、39.6±2.9、38.5±4.5、30.3±2.8;患者手术前后QOL变化有统计学意义(F=591.1,P<0.001);术后骨水泥外渗率为26.4%(14/53);有4例患者(股骨3例、肱骨1例)在术后出现病理性骨折行外科固定治疗。结论:C臂CT引导下微波消融联合骨成形术治疗四肢骨骨转移瘤是一种安全有效的治疗方法,可显著缓解患者疼痛,提高生活质量。Objective:To evaluate the safety and efficacy of C-arm CT-guided microwave ablation combined with percutaneous osteoplasty(POP)for the treatment of extremity bone metastases.Methods:Fifty-three cases of microwave ablation combined with POP for the treatment of extremity bone metastases caused by intractable pain were retrospectively collected from January 2016 to January 2023 in our hospital,and the changes of visual analog score(VAS),oswestry disability index(ODI),and quality of life scale(QOL)were evaluated regularly before and after the treatments as well as the postoperative complications were observed.Results:The success rate of surgery was 100%.The VAS scores were 7.6±1.1,7.7±0.9,2.4±1.0,1.7±0.7,1.6±1.1 and 2.3±1.3 before procedure,at 1 day,1 week,1 month,3 months,6 months after procedure,respectively.The changes in the VAS before and after procedure were statistically significant(F=143.4,P<0.001).The ODI scores were 46.8±1.8,45.4±2.0,18.3±2.8,16.7±2.6,18.0±4.5 and 24.7±1.8 before procedure,at 1 day,1 week,1 month,3 months,6 months after procedure,respectively.The changes in the ODI before and after procedure were statistically significant(F=91.8,P<0.001).The QOL scores were 24.5±3.8,25.8±2.4,38.8±2.7,39.6±2.9,38.5±4.5 and 30.3±2.8 before procedure,at 1 day,1 week,1 month,3 months,6 months after procedure,respectively.The changes in the QOL before and after procedure were statistically significant(F=591.1,P<0.001).The extravasation rate of bone cement was 26.4%(14/53).4 patients(3 femurs,1 humerus)had pathological fracture after operation and were treated with surgical fixation.Conclusion:C-arm CT-guided microwave ablation combined with POP for the treatment of extremity bone metastases is a safe and effective treatment method,which can significantly relieve patients'pain and improve their quality of life.

关 键 词：微波消融 骨成形术 骨转移瘤 

分 类 号：R738.3[医药卫生—肿瘤]