【摘要】 目的观察CT三维导航系统引导定位下椎体成形术切除小儿特殊部位血管瘤(IH)对于血清血管内皮生长因子(VEGF)与尿碱性成纤维细胞生长因子(b FGF)水平的影响。方法采用回顾性研究方法,选取2015年6月至2017年6月榆林市第一医院收治的47例椎体IH患儿,按照引导方式不同将其分为两组,对照组患儿(n=23)常规行C形臂X线机引导下椎体成形术,观察组患儿(n=24)行基于CT三维导航系统引导下椎体成形术,比较两组患儿的穿刺成功率,骨水泥充盈率,骨水泥使用量,手术前后疼痛视觉模拟评分(VAS)及血清VEGF、尿b FGF的变化情况,以及术后7 d内的并发症发生情况。结果观察组患儿的穿刺成功率(100%vs. 73. 91%)、骨水泥充盈率(100%vs. 82. 61%)均高于对照组(P <0. 05),骨水泥使用量(3. 32±1. 13 ml vs. 5. 61±1. 24ml)低于对照组(P <0. 05);两组患儿术前、术后7 d的血清VEGF、尿bFGF及VAS差异均具有统计学意义(P <0. 05),且观察组患儿术后的血清VEGF(120. 5±75. 4 pg/ml vs. 209. 5±72. 6 pg/ml)、尿b FGF(13. 5±6. 5 pg/ml vs. 22. 9±7. 2 pg/ml)及VAS评分(1. 1±0. 9分vs. 2. 2±1. 2分)明显低于对照组,差异有统计学意义(P <0. 05);观察组患儿术后7 d内的并发症发生率明显低于对照组(12. 50%vs. 47. 83%),差异有统计学意义(P <0. 05)。结论 CT引导定位下切除小儿特殊部位血管瘤有助于提高穿刺成功率和骨水泥充盈率,减少骨水泥使用量,改善术后疼痛,减少并发症,降低患儿血清VEGF、尿b FGF水平,对治疗有积极影响。更多还原

【Abstract】 Objective To observe the effect of vertebral body angioplasty(IH) on serum vascular endothelial growth factor(VEGF) and urinary basic fibroblast growth factor(bFGF) in patients with vertebral body surgery under CT guided three-dimensional navigation system.Methods A retrospective study was conducted to select 47 children with vertebral IH admitted to the First Hospital of Yulin City from June 2015 to June 2017. They were randomly divided into two groups according to different guiding methods. The control group(n = 23) Conventional C-arm X-ray machine guided vertebral body angioplasty,the observation group of children(n = 24) based on CT three-dimensional navigation system guided vertebroplasty,comparing the puncture success rate of the two groups of children,bone Cement filling rate,bone cement usage,visual analogue scale(VAS) before and after surgery,changes in serum VEGF,urinary bFGF,and complications within 7 days after surgery. Results The puncture success rate(100% vs. 73. 91%) and bone cement filling rate(100% vs. 82. 61%) were higher in the observation group than in the control group(P < 0. 05),and the amount of cement used was 3. 32 ± 1. 13 ml vs. 5. 61 ± 1. 24 ml) was lower than the control group(P < 0. 05). There were significant differences in serum VEGF,urinary bFGF and VAS between the two groups before and after 7 days(P <0. 05). After serum VEGF(120. 5 ± 75. 4 pg/ml vs. 209. 5 ± 72. 6 pg/ml),urine b FGF(13. 5 ± 6. 5 pg/ml vs. 22. 9 ± 7. 2 pg/ml) and VAS score(1. 1 ± 0. 9 points vs. 2. 2 ± 1. 2 points) was significantly lower than the control group,the difference was statistically significant(P <0. 05). The incidence of complications within 7 days after operation in the observation group(12. 50% vs. 47. 83%) was significantly lower than the control group,the difference was statistically significant(P < 0. 05). Conclusion Resection of hemangioma in children with CT-guided positioning can improve the success rate of puncture and bone cement filling rate,reduce the amount of bone cement used,improve postoperative pain,reduce complications,and reduce serum VEGF and urinary bFGF levels in children. Have a positive impact.更多还原