摘要
目的探讨CT引导下射频消融(RFA)治疗转移性骨肿瘤的疗效。方法对20例恶性肿瘤骨转移患者静脉麻醉下行CT引导下RFA治疗骨肿瘤,采用简明疼痛调查表(BPI)观察术后24 h,3、6个月疼痛评分。结果全组20例治疗后随访6个月全部存活,术前20例患者平均每日最强疼痛评分为8.1分(范围6～10)。RFA术后24 h,1、3和6个月治疗后平均最强疼痛评分分别减低为6.1、4.6、3.3和3.0分(P<0.001)。治疗前每日平均疼痛评分为6.3分,RFA术后24 h,1、3和6个月平均疼痛评分分别减低为4.0、2.3、2.1和1.9分(P<0.01)。RFA术后所有患者KPS积分都有所提高,随访患者骨肿瘤CT值有下降。所有患者术中及术后随访未出现明显的并发症。1例椎板破坏患者RFA术后有下部肢体感觉减退,给予泼尼松注射后,48 h内下部肢体感觉恢复。结论CT引导下RFA治疗骨肿瘤,近期疗效确切,具有良好的止痛效果,是一种新颖、安全、有效、并发症少的微创治疗方法。
Objective To investigate the clinical efficacy of CT-guided radiofrequency ablation （RFA） for the treatment of metastatic bone neoplasms. Methods Under intravenous aneaesthesia, CT-guided RFA was performed in 20 patients with metastatic bone tumor. The degree of pain was evaluated at 24 hours, 3 and 6 months after the operation by brief pain inventory （BPI）. Results All patients were followed up for 6 months and survived so far. The average peak pain score before the operation was 8.1 （6 - 10）.which decreased significantly to 6.1, 4.6, 3.3 and 3.0 at 24 hours, 1, 3 and 6 months after the operation respectively （P 〈 0.001 ）. The mean pain score before the operation was 6.3, which decreased significantly to 4.0, 2.3, 2.13 and 1.9 at 24 hours, 1, 3 and 6 months after the operation respectively （P 〈 0.001）. After RFA treatment, the KPS scores of all patients increased while the CT values of the bone lesions decreased. No major complications occurred both during and after the operation. One patient with vertebral lamina destruction suffered from lower limb hypoesthesia after RFA procedure, and the lower limb sensation was restored within 48 hours after the injection of prednisone was employed. Conclusion CT-guided radiofrequency ablation is a safe, effective, minimally-invasive and up-to-date technique for the treatment of metastatic bone neoplasms with excellent anti-pain effect, its short-term response is sure and reliable.
出处
《介入放射学杂志》
CSCD
北大核心
2009年第5期344-347,共4页
Journal of Interventional Radiology
关键词
骨肿瘤
射频消融
CT引导
介入治疗
bone neoplasm
radiofrequency ablation
CT-guidance
interventional treatment
