经皮穿刺椎体成形术治疗脊柱转移瘤  

Percutaneous Vertebroplasy of Vertebral Metastases

作　　者：陆军[1] 张贵祥[2] 范黎[3] 石梅[1] 韩良辅[1] 赵海涛[2] 

机构地区：[1]第四军医大学西京医院放疗科,陕西西安710032 [2]第四军医大学西京医院放射科,陕西西安710032 [3]第四军医大学西京医院肿瘤科,陕西西安710032

出　　处：《实用放射学杂志》2003年第2期154-157,共4页Journal of Practical Radiology

摘　　要：目的　评价经皮穿刺椎体成形术治疗伴有疼痛或脊柱不稳椎体转移瘤的作用。方法　在CT引导下 5 4位患者 5 7次操作中共 72例次椎体接受经皮穿刺椎体成型术治疗。其中 46次操作为了止痛 ,5次为了稳定脊柱 ,6次二者兼之。采用随访统计对治疗效果评价。结果　在 5 2次止痛操作中 ,39次获得了明显的疼痛症状缓解 ,7次获得轻度缓解 ,6次无改善。随访至 6个月时73.6%的改善效果仍稳定 ,1年 65 .6%的治疗仍有效。针对脊柱稳定性的治疗 ,随访没有发现任何移位、变形等改变。 3次操作由于骨水泥的刺激出现神经放散痛 ,2次操作由于推移肿瘤组织而压迫脊髓。结论　脊柱转移瘤的椎体成型术治疗是一种微创操作 ,其可立刻获得止痛效果并长期有效 。Objective To study the efficacy of percutaneous vertebroplasty in treating spinal metastases that result in pain or instability.Methods Fifty-four patients(32 men,22 women;aged 30～88 years)underwent 72 percutaneous injections of surgical cement into a vertebra(vertebtoplasty)with CT guidance in 57 procedures.Vertebroplasty was performed for local analgesia in 46 procedures,stabilization of the vertebral column in five procedures,and both in six procedures.Results Thirty-nine of the 52 procedures performed for analgesia that were evaluated resulted in clear improvement;seven,moderate improvement;and six,no improvement.Improvement was stable in 73.6% of patients at 6 months.In the procedure performed for stabilization,no displacement of treated vertebrae was observed.Three patients had transient radiculopathy due to cement stimulation and two patients had pressure symptoms of spinal cord by tumor tissue.Conclusion Vertebroplasty of metastases is a minimally invasive procedure that provides immediate and long-term pain relief and contributes to spinal stabilization.

关 键 词：脊柱转移瘤 经皮穿刺椎体成形术 CT引导 止痛效果 脊柱稳定性 并发症 禁忌症 

分 类 号：R738.1[医药卫生—肿瘤] R730.56[医药卫生—临床医学]