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目的探讨经皮椎体成形术(PVP)联合~(125)Ⅰ粒子植入治疗脊柱转移瘤患者的临床疗效。方法将80例脊椎转移瘤患者,随机分为单纯PVP组40例,PVP联合~(125)Ⅰ粒子植入组(联合治疗组)40例。单纯PVP组是在DSA机引导下经皮穿刺,将骨水泥注射到患椎内。联合治疗组是PVP术中联合~(125)Ⅰ粒子植入。结果联合治疗组和单纯PVP组术后KPS评分分别为(92.5±7.1)分及(87.7±7.3)分,较术前(68.9±7.9)分及(69.4±8.3)分明显增高,两组比较差异有统计学意义(P<0.05)。联合治疗组肿瘤进展时间(TTP)为9.0个月,单纯PVP组TTP为8.9个月。结论PVP具有创伤小,操作较简单,并发症少的特点,可有效缓解脊柱转移瘤患者疼痛,PVP术中联合~(125)Ⅰ粒子植入能增强抗肿瘤作用,从而达到提高疗效的目的。
Objective To investigate the clinical effect of percutaneous vertebroplasty (PVP) combined with ~ (125) Ⅰ particle implantation in patients with spinal metastases. Methods Totally 80 patients with spinal metastases were randomly divided into PVP group (n = 40) and PVP group (n = 125) Ⅰ particles implantation group (n = 40). Pure PVP group is under the guidance of DSA machine percutaneous puncture, the bone cement injection into the affected vertebra. Combination therapy group is PVP intraoperative combined 125I Ⅰ particle implantation. Results The postoperative KPS scores of the combination therapy group and PVP group were (92.5 ± 7.1) and (87.7 ± 7.3) points, respectively, which were significantly higher than those of preoperative (68.9 ± 7.9) and (69.4 ± 8.3) points The difference was statistically significant (P <0.05). The time to tumor progression (TTP) in the combination therapy group was 9.0 months, and the TTP in the PVP group alone was 8.9 months. Conclusion PVP has the advantages of less trauma, simpler operation and fewer complications, which can effectively relieve the pain of patients with spinal metastases. The combination of PVP intraoperatively with 125I seeds can enhance the anti-tumor effect and achieve the goal of improving the curative effect.