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目的比较氩氦刀或唑来膦酸单一治疗和联合治疗骨转移癌疼痛的疗效和安全性。方法 84例患者随机分为A组(联合)、B组(氩氦刀)、C组(唑来膦酸)各28例;A组氩氦刀冷冻消融治疗结束后给予唑来膦酸注射液4 mg加入0.9%氯化钠注射液100 ml静脉滴注15 min以上;B组单一使用氩氦刀冷冻消融骨转移癌局部组织;C组给子唑来膦酸注射液4 mg加入0.9%氯化钠注射液100 ml静脉滴注15 min以上。结果①A组止痛总有效率为85.7%,其中显效为35.7%(10/28),有效为50.0%(14/28);B组止痛总有效率为50.0%,其中显效为14.3%(4/28),有效为35.7%(10/28),C组总有效率为67.9%(19/28),其中显效为21.4%(6/28),有效为46.4%(13/28),3组间比较差异有统计学意义(P<0.05)。②平均起效时间:A组为(1.96±2.26)d,B组为(1.43±1.79)d,C组为(11.67±3.14)d,A、B两组与C组之间差异有统计学意义(P<0.05)。③疗效维持时间:A组为(146.68±1.89)d,B组为(71.60±2.94)d,C组为(112.99±1.37)d,3组间比较差异有统计学意义(P<0.01)。结论氩氦刀冷冻消融联合唑来膦酸治疗骨转移癌性疼痛是一种安全、有效的技术。
Objective To compare the efficacy and safety of argon-helium knife or zoledronic acid monotherapy and combined treatment of bone metastases pain. Methods 84 patients were randomly divided into A group (combination), B group (argon helium knife), C group (zoledronic acid) of 28 cases; A group of argon-helium knife after cryoablation was given zoledronic acid injection 4 mg 0.9% sodium chloride injection 100 ml intravenous infusion of 15 min or more; B group with a single argon-helium knife cryogenic ablation of bone metastases local tissue; C group to sub-zoledronic acid injection 4 mg 0.9% chlorine Sodium injection 100 ml intravenous infusion of 15 min or more. Results ① The total effective rate of analgesic in group A was 85.7%, of which 35.7% (10/28) was markedly effective and 50.0% (14/28) in effective rate. The total effective rate of analgesic in group B was 50.0%, and the effective rate was 14.3% 28), the effective rate was 35.7% (10/28), the total effective rate in group C was 67.9% (19/28), and the effective rate was 21.4% (6/28) and 46.4% (13/28) The difference was statistically significant (P <0.05). ② The mean effective time was (1.96 ± 2.26) days in group A, (1.43 ± 1.79) days in group B and (11.67 ± 3.14) days in group C, respectively. The difference between group A and group B was statistically significant Significance (P <0.05). (3) The duration of efficacy maintenance was (146.68 ± 1.89) days in group A, (71.60 ± 2.94) days in group B and (112.99 ± 1.37) days in group C, with significant differences between the three groups (P <0.01). Conclusion Cryosurgery with argon-helium knife combined with zoledronic acid is a safe and effective technique in the treatment of cancer pain with bone metastases.