摘要
目的探讨放射性^(125)I粒子联合骨水泥椎体成形术治疗脊柱成骨性转移瘤的临床价值。方法选取脊柱成骨性转移瘤患者80例,随机分为对照组和观察组,每组40例。对照组行单纯骨水泥椎体成形术治疗,观察组行放射性^(125)I粒子联合骨水泥椎体成形术治疗。观察患者视觉模拟(VAS)评分及功能障碍指数(ODI)评分、生活质量调查表(QQL)评分变化,骨水泥渗透、^(125)I粒子外漏、脊髓神经根损伤、血肿、感染等并发症发生情况。结果2组术前VAS、ODI、QQL评分比较差异无统计学意义(P>0.05),手术后VAS及ODI评分较术前降低,QQL评分较术前升高,手术前后不同时点以上评分比较差异有统计学意义(P<0.001)。术后1周、1月、3月、6月时VAS评分与术前组内比较下降(P<0.001),术后1月、3月、6月时VAS评分与术后1周时组内比较下降(P<0.001),术后1月、3月、6月时VAS评分组间观察组低于对照组(P<0.001)。术后1周、1月、3月、6月时ODI评分与术前组内比较降低(P<0.001),观察组术后1月、3月、6月时ODI评分与术后1周时比较降低(P<0.001),术后1周、1月、3月、6月时评分观察组低于对照组(P<0.001)。手术后1周、1月、3月、6月时QQL评分与术前比较升高(P<0.001),术后1月、3月QQL评分与术后1周时组内比较升高(P<0.05),术后1周、1月、3月、6月时QQL评分观察组高于对照组(P<0.001)。2组患者均未发生脊髓神经损伤、血肿及感染,观察组未出现^(125)I粒子外漏情况。骨水泥渗透发生率对照组为15.00%,观察组为15.50%,比较差异无统计学意义(P>0.05)。结论放射性^(125)I粒子联合骨水泥椎体成形术治疗脊柱成骨性转移瘤更有助于改善患者疼痛感和生活质量,且效果优于单纯的骨水泥椎体成形术,具有可行性及安全性。
Objective To discuss the clinical application of^(125)I radioactive particles combined with bone cement implantation treating osteoblastic spinal metastases.Methods 80 cases patients with osteoblastic spinal metastases,they were randomly divided into the control group and the observation group with 40 cases in each group,the control group was treated with bone cement vertebroplasty,the observation group was treated with^(125)I radioactive particles combined with bone cement implantation,to observed visual analogue scale(VAS)score,oswestry disability index(ODI)score and quality of Life questionnaire(QQL)score,and complications such as bone cement penetration,^(125)I particle leakage,spinal cord nerve root injury,hematoma and infection.Results There was no significant difference in preoperative VAS,ODI and QQL scores between the two groups(P>0.05).VAS and ODI scores after surgery were lower than those before surgery,and QQL scores were higher than those before surgery,the difference of scores at different time points before and after operation was statistically significant(P<0.001).VAS score were 1 week,1 month,3 months and 6 months after surgery lower than that before surgery(P<0.001),VAS score were 1 month,3 months and 6 months after surgery lower than that 1 week after surgery(P<0.001),VAS score were the observation group lower than that in the control group at 1 month,3 months and 6 months after surgery(P<0.001).ODI score were 1 week,1 month,3 months and 6 months after surgery lower than that before surgery(P<0.001),ODI score were 1 month,3 months and 6 months after surgery lower than that 1 week after surgery of the observation group(P<0.001),ODI score were the observation group lower than that in the control group at 1 month,3 months and 6 months after surgery(P<0.001).QQLscore were 1 week,1 month,3 months and 6 months after surgery higher than that before surgery(P<0.001),QQL score were 1 month and 3 months after surgery higher than that 1 week after surgery(P<0.001),QQL score were the observation group high
作者
徐杰
胡亚辉
王雪伟
于亚倩
常晓朋
XU Jie;HU Yahui;WANG Xuewei(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou,450007)
出处
《实用癌症杂志》
2021年第9期1545-1549,共5页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划项目(编号:2018063112)。
