椎体成形术联合微波消融治疗转移癌致椎体压缩性骨折  

Vertebroplasty combined with microwave ablation for treating vertebral compression fractures caused by metastatic cancer

作　　者：邱媛媛 邢超 袁倩倩 张开贤 张旭升 QIU Yuanyuan;XING Chao;YUAN Qianqian;ZHANG Kaixian;ZHANG Xusheng(Department of Oncology,Tengzhou Central People’s Hospital Affiliated to Jining Medical College,Tengzhou 277500,China)

机构地区：[1]济宁医学院附属滕州市中心人民医院肿瘤科,山东滕州277500

出　　处：《中国介入影像与治疗学》2025年第1期11-15,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的 观察经皮椎体成形术(PVP)联合微波消融(MWA)治疗转移癌致椎体压缩性骨折(VCF)效果。方法回顾性分析112例转移癌致VCF患者,其中77例共105节椎体接受MWA联合PVP(A组)、35例共68节椎体接受单纯PVP(B组)。记录技术成功率及并发症,对比治疗后患者疼痛视觉模拟(VAS)评分、每日吗啡消耗量(DMC)及Oswestry功能障碍指数(ODI),观察局部肿瘤复发率。结果MWA及PVP技术成功率均为100%。A组12例(12/77,15.58%)、B组19例(19/35,54.29%)见骨水泥渗漏,A组低于B组(P<0.001);未见其他并发症。治疗后1周及1、3、6个月,2组疼痛VAS评分、DMC和ODI均较治疗前降低(P均<0.001);A组治疗后3及6个月疼痛VAS评分均低于B组(P均<0.01),A组治疗后6个月DMC及ODI均低于B组(P均<0.01),其余各时间点组间疼痛VAS评分、DMC及ODI差异均无统计学意义(P均>0.05)。治疗后6个月,A组[17.14%(18/105)]病变局部肿瘤复发率明显低于B组[32.35%(22/68)],差异有统计学意义(P=0.020)。结论 PVP联合MWA治疗转移癌致VCF可减少并发症、延长疼痛缓解时间,且短期局部控制肿瘤效果更佳。Objective To observe the efficacy of percutaneous vertebroplasty(PVP)combined with microwave ablation(MWA)for treating vertebral compression fractures(VCF)caused by metastatic cancer.Methods Totally 112 patients with VCF caused by metastatic cancer were retrospectively enrolled,including 77 cases(105 vertebrae)underwent MWA+PVP(group A)and 35 cases(68 vertebrae)who underwent PVP alone(group B).The success rates of the treatments were recorded,and complications were observed.Visual analogue scale(VAS)score of pain,daily morphine consumption(DMC)and Oswestry disability index(ODI)of patients were compared within and between groups after treatments,and local tumor recurrence rates after treatment were observed.Results The success rates of MWA and PVP were both 100%.After treatments,bone cement leakage occurred in 12 cases(12/77,15.58%)in group A and 19 cases(19/35,54.29%)in group B,in group A was lower than in group B(P<0.001).No other complications occurred.One week and 1,3 and 6 months after treatments,VAS scores of pain,DMC and ODI in group A and B were all lower than those before treatments(all P<0.001).Three and 6 months after treatments,VAS scores of pain in group A were lower than those in group B(both P<0.01),while 6 months after treatments,DMC and ODI in group A were lower than those in group B(both P<0.01).No significant difference of VAS scores of pain,DMC nor ODI was found between groups at the other time points(all P>0.05).Six months after treatments,local tumor recurrence rate in lesions in group A(17.14%,18/105)was significantly lower than that in group B(32.35%,22/68)(P=0.020).Conclusion For treating VCF caused by metastatic cancer,PVP combined with MWA could reduce incidence of complications,prolong pain relief time and bring better short-term local tumor control effect.

关 键 词：骨折 压缩性 肿瘤转移 椎体成形术 微波消融 

分 类 号：R683.2[医药卫生—骨科学] R815[医药卫生—外科学]