【摘要】 目的探讨微波消融(MWA)联合经皮椎体成形术(PVP)治疗脊柱转移性肿瘤的疗效。方法选择2017年1月—2019年7月在本院应用MWA联合PVP治疗脊柱转移性肿瘤患者22例作为研究对象,共31节受累椎体,其中胸椎18节,腰椎13节,所有患者均有不同程度胸背部或者腰部疼痛。所有患者在DSA引导下,接受MWA联合PVP治疗。采用疼痛视觉模拟评分(VAS)对患者术前和术后的疼痛状况进行评估,患者术后3个月行病变椎体的MR或CT检查,评估脊柱转移性肿瘤局部控制情况。结果所有手术顺利完成,患者术后1 d、1周、1个月及3个月VAS评分均明显低于术前(P<0.05),患者疼痛明显缓解,术后各时间点VAS评分无明显差异(P>0.05),患者术后疼痛缓解基本稳定。患者术后3个月通过MR或CT检查,21例患者脊柱转移性肿瘤得到较好控制,仅1例患者骨水泥旁有新发骨质破坏。结论 MWA联合PVP治疗脊柱转移性肿瘤可获得较好的近期临床效果,可有效改善患者生存质量。更多还原

【Abstract】 Objective To discuss the clinical effectiveness of microwave ablation(MWA) combined with percutaneous vertebroplasty(PVP) for the treatment of spinal metastatic tumors.Methods 22 case of patients with spinal metastatic tumors those who treated by MWA and PVP in our hospital from January 2017 to July 2019 were selected as study subjects. A total of 31 involved vertebrae were detected, including 18 thoracic vertebrae and 13 lumbar vertebrae. All patients presented a thoracodorsal or lumbago pain of different degrees.Guided by DSA,all patients were treated with microwave ablation combined with percutaneous vertebroplasty.Pain visual analogue scale( VAS) was used to evaluate the preoperative and postoperative pain severity. MR or CT examination on diseased vertebrae was performed among the patients 3 months after operation to evaluate the local control of spinal metastases. Results The procedures were successfully completed for all patients. VAS scores on 1 st day,1 st week,1 th month and 3 rd month after operation were significantly lower than those before operation( P< 0. 05),patients felt significant pain relief. There were no significant difference in VAS scores at different time points after operation( P > 0. 05),patients achieved basically stable pain relief. MR or CT examination 3 months after operation revealed that spinal metastases was well controlled in 21 cases of the patients,only 1 patient presented new bone destruction beside bone cement. Conclusions Microwave ablation combined with percutaneous vertebroplasty in the treatment of spinal metastatic tumors could obtain an excellent short term effect,and it could markedly improve the quality of life of the patients.更多还原