摘要
目的研究CT引导下125I粒子植入联合经皮椎体成形术(PVP)治疗椎体转移性肿瘤的临床效果和预后情况。方法选取2012年1月~2013年12月间来我院进行治疗的椎体转移性肿瘤48例,按照随机数字表法分为观察组24例和对照组24例。对照组患者采用传统的手术切除方式治疗,观察组采用CT引导下125I粒子植入联合经皮椎体成形术PVP治疗。收集两组患者的年龄、性别、原发类型、疼痛等级等一般资料,统计两组患者治疗后的有效率和并发症发生情况,并对收集的数据进行统计学分析。结果观察组患者治疗有效率为79.2%,对照组的治疗有效率为50.0%,两组比较差异具有统计学意义(P<0.05)。术后并发症观察组发生率为16.7%,远远低于对照组的79.1%,两组比较差异具有统计学意义(P<0.05)。观察组24例患者共34节椎体,均顺利完成125I粒子植入联合经皮椎体成形术治疗,手术成功率为100%。其中使用1、2、3根粒子针分别植入12、14、8节椎体。治疗后观察组患者睡眠质量普遍优于对照组,其抑郁程度亦较低,两组比较差异有统计学意义(P<0.01);分别与治疗后24 h、14 d NIHSS评分进行测定,同时进行组间比较,数据结果显示观察组评分更低(P<0.05)。结论 CT引导下125I粒子植入联合经皮椎体成形术治疗椎体转移性肿瘤效果良好,能够有效缓解患者的疼痛;并发症发生率低,能够控制肿瘤的发展,值得临床推广。
Objective To study the clinical efficacy and prognosis of implantation of 125I seeds under CT direction com-bined with percutaneous vertebroplasty （PVP）in the treatment of vertebral metastatic tumors. Methods All 48 patients with vertebral metastatic tumors who were treated in our hospital from January 2012 to December 2013 were selected. They were assigned to observation group and control group according to random number table,with 24 patients in each group. Patients in the control group were given conventional surgical incision, and patients in the observation group were given the treatment of 125I seeds under CT direction combined with PVP. General data such as age, gender, pri-mary type, and pain degree in both groups were collected, efficacy and complications after the treatment in both groups were statistically collected, and statistical analysis was carried out for the collected data. Results Effective rate of treatment was 79.2% in the observation group, and effective rate of treatment was 50.0% in the control group. The difference of both groups was statistically significant（P〈0.05）. Incidence of postoperative complications was 16.7%in the observation group, significantly lower than 79.1% in the control group. The difference of both groups was statistically significant （P〈0.05）. A total of 34 centrums in 24 patients in the observation group all successfully completed the treatment of 125I seeds combined with PVP,and the successful rate of surgery was 100%. 1,2 and 3 seed needles were used to be implanted into 12,14 and 8 centrums respectively. Sleeping quality of patients in the observation group was generally better than that in the control group, and their depression degree was also lower. The comparison between both groups was significant （P〈0.01）; NIHSS scores of 24 hours and 14 days after the treatment were measured,and the scores between both groups were compared. Results showed that the scores in the observation group were lower（P〈0.05）. Conclusion Implantation of 125I seeds under CT direction combined with percutaneous vertebroplasty in the treatment of vertebral metastatic tumors has a favorable efficacy, and is able to effectively alleviate patients＇ pain; the treatment has a low incidence of complications and is able to control the development of tumors, which is worthy of clinical promotion.
出处
《中国现代医生》
2015年第19期109-112,116,共5页
China Modern Doctor
基金
浙江省医药卫生一般研究计划(2012KYB220)
