微波消融联合经皮骨成形术治疗扁骨转移瘤的临床疗效评价  

Evaluation of the clinical efficacy of microwave ablation combined with percutaneous osteoplasty in the treatment of flat bone metastases

作　　者：林志鹏 胡小龙 黄大钡[1] 邹旭公 陈源[1] 朱康顺 张健[1] 李晓群[1] LIN Zhipeng;HU Xiaolong;HUANG Dabei;ZOU Xugong;CHEN Yuan;ZHU Kangshun;ZHANG Jian;LI Xiaoqun(Department of Interventional Medicine,Zhongshan Municipal People's Hospital,Zhongshan,Guangdong Province 528499,China)

机构地区：[1]中山市人民医院介入医学科,广东中山528499 [2]广州医科大学附属第二医院微创介入科

出　　处：《介入放射学杂志》2024年第9期976-982,共7页Journal of Interventional Radiology

摘　　要：目的 评估微波消融联合经皮骨成形术(POP)治疗扁骨转移瘤的临床疗效、安全性及效价比。方法 纳入2016年1月至2023年1月在中山市人民医院行微波消融联合POP(联合治疗)及单纯POP治疗的57例扁骨转移瘤伴顽固性疼痛患者,其中联合治疗组36例,单纯POP治疗组21例。采用视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、生活质量评价表(QOL)评分定期评价术前及术后不同时期的疗效,并进行两组比较,观察两组相关并发症发生情况。结果 57例手术成功率100%,术后无严重手术并发症发生。随访(4.7±1.3)个月(3.4~7.2个月)。术前、术后1 d、1周、1个月及3个月VAS评分,联合组分别为(7.39±1.09)、(6.53±1.17)、(1.94±0.70)、(1.11±0.66)、(1.39±0.59)分,单纯POP组分别为(7.52±1.01)、(6.81±0.66)、(3.38±0.65)、(2.33±0.56)、(2.52±0.50)分;术后1周联合组VAS评分下降了(5.44±1.32)分,单纯POP组下降了(4.14±0.96)分;术后各随访点VAS评分两组间比较,术后1周(t=-7.62、P<0.01)、术后1个月(t=-7.28、P<0.01)、术后3个月(t=-7.58、P<0.01),差异均有统计学意义。术前、术后1 d、1周、1个月及3个月ODI评分,联合组分别为(44.33±2.91)、(44.08±2.82)、(15.92±3.04)、(14.00±2.39)、(16.08±3.61)分,单纯POP组分别为(45.67±3.03)、(45.14±2.80)、(22.38±3.09)、(19.76±2.99)、(22.10±3.10)分;术后1周联合组ODI评分平均下降了(28.42±4.23)分,单纯POP组下降了(23.29±4.28);术后各随访点ODI评分两组间比较,术后1周(t=-7.50、P<0.01)、术后1个月(t=-7.37、P<0.01)、术后3个月(t=-6.51、P<0.01),差异均有统计学意义。术前、术后1 d、1周、1个月及3个月QOL评价,联合组分别为(24.69±3.92)、(26.06±3.05)、(38.67±3.00)、(40.25±3.42)、(39.58±3.99)分,单纯POP组分别为(24.43±3.53)、(26.76±3.05)、(32.81±2.17)、(33.95±2.68)、(31.19±4.27)分,术后1周联合组QOL评分上升了(13.97±4.88)分,单纯POP组上升了(8.38±4.50)分;术�Objective To evaluate the clinical efficacy,safety,and potency ratio of microwave ablation(MWA)combined with percutaneous osteoplasty(POP)for the treatment of flat bone metastases.Methods A total of 57 patients with flat bone metastases complicated by intractable pain,who underwent MWA combined with POP(combination therapy)or only POP(pure POP therapy)at the Zhongshan Municipal People′s Hospital of China between January 2016 and January 2023,were enrolled in this study.The combination therapy group had 36 patients and the pure POP therapy group had 21 patients.Visual analog scale(VAS),Oswestry Disability Index(ODI),quality of life assessment scale(QOL)were used to evaluate the preoperative and the postoperative different period efficacy,and the results were compared between the two groups.The procedure-related complications in both groups were recorded.Results The technical success rate in the 57 patients was 100%,and no serious postoperative complications occurred.The mean follow-up time was(4.7±1.3)months(range of 3.4-7.2 months).The preoperative and the postoperative one-day,one-week,one-month and 3-month VAS scores in the combination therapy group were(7.39±1.09)points,(6.53±1.17)points,(1.94±0.70)points,(1.11±0.66)points and(1.39±0.59)points respectively,which in the pure POP therapy group were(7.52±1.01)points,(6.81±0.66)points,(3.38±0.65)points,(2.33±0.56)points and(2.52±0.50)points respectively.One week after operation,the VAS scores in the combination therapy group and the pure POP therapy group were decreased by(5.44±1.32)points and(4.14±0.96)points respectively.The differences in the postoperative one-week(t=-7.62,P<0.01),one-month(t=-7.28,P<0.01)and 3-month(t=-7.58,P<0.01)VAS scores between the two groups were statistically significant.The preoperative and the postoperative one-day,one-week,one-month and 3-month ODI scores in the combination therapy group were(44.33±2.91)points,(44.08±2.82)points,(15.92±3.04)points,(14.00±2.39)points and(16.08±3.61)points respectively,which in the

关 键 词：微波消融 骨成形术 扁骨转移瘤 

分 类 号：R738.1[医药卫生—肿瘤]