摘要
目的探讨经皮椎体成形术治疗椎体恶性肿瘤引起的剧烈疼痛的有效性.方法椎体恶性肿瘤患者共23例,肺癌椎体转移11例,乳腺癌椎体转移5例,骨髓瘤2例,原发性淋巴瘤2例,膀胱癌椎体转移1例,不明来源的恶性椎体肿瘤2例.诊断根据平片、CT、MR和ECT.入院时所有患者均有背部疼痛症状,6点疼痛评分为4.18±0.51分,运动能力评分4.83±0.39分.采用椎弓根入路,以配套活检针抽取组织学标本,配置1.3～1.8g/ml的骨水泥,将骨水泥缓慢注射到椎体中,使骨水泥在椎体病灶内分布、铸形.结果 23例33节椎体成形术都获得成功,每节椎体注射骨水泥0.5～7ml.术后2d评估疗效:9例患者术后疼痛完全缓解,10例明显缓解,2例中度改善,2例改善不明显.平均疼痛评分降为0.81±0.67,平均运动功能评分1.72±0.41.配对t检验术前、术后比较,有统计学意义(P＜0.01).结论采用经皮椎体成形术治疗椎体恶性肿瘤是一种创伤小、安全、有效的治疗手段,可以明显提高晚期恶性椎体肿瘤患者的生存质量.
Objective To investigate the efficiency of the treatment of unbearable and severe pain induced by vertebral malignant tumors with percutaneous vertebroplasty.Methods The treatment of 23 cases of was reported. There were 11 cases of vertebral metastatic lesions from lung cancer, 5 metastasized from breast cancer, one from bladder cancer, 2 cases of myeloma, 2 cases of malignant lymphoma, and 2 cases of malignant tumors with unknown origin. Diagnosis was made by X-ray film, CT, MR, and ECT. All the patients were suffering from severe lumbar and back pain when admitted to hospital. The average score of the 6-point bahavioral rating pain scale was 4.18±0.51, and the average score of ambulation was 4.83±0.39. Transpedicular approach was used, and tissue in the lesions was taken with biopsy needles at first. 1.3~1.8g/ml of bone cement was injected into the vertebral bodies and made to distribute and cast in the lesions. Results There were 33 procedures in 23 cases. 0.5-7ml of cement was injected into the lesions per vertebra. The evaluation was made 2 days after the procedures. Complete relief was got in 9 cases, obvious relief was achieved in 10 cases, mild progress was made in 2 cases, no progress was got in 2 cases. The average score of the 6-point bahavioral rating scale dropped to 0.81±0.67, and the average score of ambulation decreased to 1.72±0.41 after the treatments. Matched t-test showed a significant difference between pre-and post-operative stage (P<0.01).Conclusions The treatment of vertebral maglinant tumors with percutaneous vertebroplasty was mini-invasive, safe, and effective. It greatly helped to improve the quality of life of the patients in the late stage of malignant tumors.
出处
《中华神经外科杂志》
CSCD
北大核心
2005年第7期412-415,共4页
Chinese Journal of Neurosurgery
基金
首都医科大学基础临床合作基金重点项目(2004JLO7)
2003年北京市优秀人才培养专项基金项目
