摘要
目的探讨经皮穿刺射频消融(RFA)联合球囊扩张椎体后凸成形术(PKP)治疗脊柱转移癌的临床疗效。方法回顾性分析溶骨性脊柱转移癌患者的临床资料,其中18例行经皮穿刺球囊扩张椎体后凸成形术(PKP组),20例行经皮穿刺射频消融联合椎体后凸成型术(RFA+PKP组)。PKP组中男10例,女8例,年龄(49.0±8.3)岁;PKP+RFA组中男11例,女9例,年龄(50.0±7.6)岁。记录术前、术后视觉模拟评分(VAS)评估患者疼痛情况,罗兰-摩理斯生活障碍问卷表(RMDQ)评估患者功能障碍情况,观察2组患者骨水泥外渗情况及术后肿瘤复发率。结果术后随访8~19个月,PKP组(13.28±2.23)个月,PKP+RFA组(13.69±1.85)个月。PKP组VAS评分从术前的(8.92±0.79)分降至(3.11±0.65)分,PKP+RFA组从术前的(8.75±0.86)分降至(2.77±0.89)分,2组术前、术后比较差异有统计学意义(P<0.05);术前和术后6个月时2组患者VAS评分差异无统计学意义(P>0.05)。2组患者术后6个月时RMDQ较术前均有所改善,但2组比较差异无统计学意义(P>0.05)。PKP组骨水泥外渗率为21.12%,PKP+RFA组为12.02%;PKP组肿瘤复发率为31.21%,PKP+RFA组为9.11%,2组患者骨水泥外渗率及术后肿瘤复发率差异有统计学意义(P<0.05)。结论 PKP+RFA治疗脊柱溶骨性转移瘤可取得与PKP相似的临床疗效,短期内可控制癌灶发展,改善患者生活质量。
Objective To explore the clinical curative effectefficacy and safety of combination treatment with the technology that RFA combined withand PKP to the spinal metastases. Methods 18 cases of patients were operated with PKP, 18 underwent PKP Group, 10 male cases and 8 female inccases, average age was 49.0 ± 8.3 ; 20 underwent RFA ＋ PKP group which were included 11 male cases and 9 female cases, average age was 50.0 ＋ 7.6. Valued the clinical curative effect through the preoperational in the first month and the sixth month of VAS, RMDQ postoperatively, and observed the bone cement leakage and tumor recurrence of the two groups after surgery. Results All cases were followed up for 8 - 19 months, （ 13.28 ± 2.23 ） months in group PKP and （ 13.69 ± 1.85 ） months in group PKP ＋ RFA. VAS was from pre - operation 8.92 ± 0.79 to post - operation 3.11 ± 0. 65 in group PKP, and VAS was from pre - opera- tion 8.75 ±0. 86 to post - operation 2.77 ± 0.89 in group PKP ＋ RFA. There were statistically significant differences two groups （ P 〈 0.05 ）. VAS of preoperative and 6 months postoperative were no significant differences （ P 〉 0.05 ）. Two groups after 6 months operation compared with preoperative RMDQ improved, VAS of two groups in postoperative wasis no statistical difference （ P 〉 0.05 ）. The bone ce- ment leakage rate was 21. 12% in group PKP and was 12.02% in group PKP ＋ RFA,tumor recurrence rate of the group PKP was 31.21% and PKP ＋ RFA was 9.11% （ P 〈 O. 05 ）. Conclusions RFA combined with PKP,which has a similar clinical curative effect to compared with PKP and it can restrain the development of the cancer in short term, also it can improve the quality of patients＇ life sig- nificantly.
作者
施建党
何胤
杨宗强
苏胜杰
牛宁奎
丁惠强
SHI Jiandang HE Yin YANG Zongqiang SU Shengjie NIU Ningkui DING Huiqiang(Department of Spine Orthopedics ,General Hospital of Ningxia Medical University, Yinchuan 750004, China Department of Orthopedics, Central Hospital of Guangyuan, Guan- gyuan 628000, China Ningxia Medical University, Yinchuan 750004, China)
出处
《宁夏医学杂志》
CAS
2017年第3期225-228,共4页
Ningxia Medical Journal
基金
宁夏卫生和计划生育委员会重点科研计划项目(2015NW023)
