【摘要】 目的:探讨CT引导多靶点经皮椎体成形术(percutaneous vertebroplasty, PVP)治疗椎体转移肿瘤疼痛的临床疗效及安全性。方法:2011年10月至2016年10月,我科应用PVP治疗椎体转移性肿瘤132例共160个椎体。在CT引导下经皮多靶点穿刺至椎体肿瘤病灶后分次、多点注入适量骨水泥,观察术前与术后1周、1月、3月疼痛视觉模拟(visual analogue scale, VAS)评分,镇痛药使用评分(analgesic use scores, AUS),病人生活质量评分(quality of life scale, QLS),手术相关并发症及骨水泥渗漏情况。结果:颈、胸、腰、骶椎骨水泥平均注射量分别是0.8±0.1 ml、2.2±1.4 ml、3.4±1.3 ml、4.2±1.7 ml。术后VAS评分、AUS评分、QLS评分与术前相比较,均有显著性差异(P <0.01)。术中出现17例(10.6%)骨水泥渗漏,其中椎管内渗漏4例、椎间盘内渗漏7例、椎旁渗漏6例,所有渗漏病例均未出现神经损伤症状。结论:CT引导下多靶点PVP可明显缓解椎体转移瘤病人的疼痛症状,显著改善病人生活质量,减少镇痛药物使用量。更多还原

【Abstract】 Objective: To evaluate the safety and efficacy of CT-guided percutaneous multi-targets vertebroplasty(PVP) in the treatment of vertebrae metastasic tumor pain. Methods: From Octomber 2011 to Octomber 2016, 132 patients(160 vertebraes) with vertebrae metastasic tumor pain were treated with multitargets PVP. Bone cement was injected into the vertebrae metastases lesions under CT guidance, the injection volume of bone cement was recorded during the procedure. The efficacy of pain control was assessed by visual analogue scale(VAS), quality of life scale(QLS) and analgesic use scores(AUS). Results: The average bone cement injection volume in cervical, thoracic, lumbar and sacral were 0.8±0.1 ml, 2.2±1.4 ml, 3.4±1.3 ml, 4.2±1.7 ml respectively. The scores of VAS, QLS and AUS were significantly decreased after operation(P < 0.01). 17 patients(10.6%) encountered bone cement leaks during surgery including 4 patients with epidural leak, 7 patients with intervertebral disc leak and 6 patients with paravertebral leak. However, no neurologic symptoms were found in all cases. Conclusion: CT-guided multi-target PVP could significantly alleviate the pain symptoms, improve the quality of life and reduce the use of analgesic drugs of patients with vertebral metastases.更多还原