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目的:探讨经皮椎体成形术治疗椎体溶骨性转移癌的临床价值。方法:应用经皮椎体成形术治疗25例33个椎体的溶骨性转移癌。在C型臂X光机透视导向下经皮穿刺到病变椎体后注入骨水泥(3~8)ml。记录患者术前、术后24h、术后1周、术后1月的疼痛视觉模拟划线得分(VAS)。观察止痛效果和并发症。结果:33个椎体皆一次穿刺成功,穿刺成功率100%。1月后疼痛缓解程度为:完全缓解(CR)者6例(6/25),部分缓解(PR)者16例(16/25),轻度缓解(MR)者2例,无效(NR)者1例,总有效率(CR+PR)为88%(22/25)。患者术前与术后24h、术后1周、术后1月的VAS的得分之间差异有统计学意义(P<0.05)。PVP术后无1例椎体塌陷加重或发生新的骨折。除6例发生无症状的骨水泥渗漏外,无1例发生严重并发症。结论:经皮椎体成形术治疗椎体的溶骨性转移癌效果良好。
Objective: To investigate the clinical value of percutaneous vertebroplasty in the treatment of vertebral osteolytic metastatic carcinoma. Methods: Percutaneous vertebroplasty was used to treat osteolytic metastatic carcinoma in 25 patients with 33 vertebrae. In the C-arm X-ray machine under the guidance of percutaneous vertebroplasty puncture the bone cement (3 ~ 8) ml. The pain visual analogue score (VAS) was recorded before operation, 24h after operation, one week after operation and one month after operation. Analgesic effects and complications were observed. Results: All the 33 vertebrae were punctured successfully, and the puncture success rate was 100%. After 1 month, the degree of pain relief was 6 cases (6/25) in complete remission (CR), 16 cases (16/25) in partial remission (PR), 2 cases in mild remission (MR) In 1 case, the total effective rate (CR + PR) was 88% (22/25). The difference of VAS score between preoperative and postoperative 24h, postoperative 1 week and postoperative January was statistically significant (P <0.05). No PVP postoperative vertebral collapse or new fractures occurred. In addition to 6 cases of asymptomatic cement leakage, no serious complications occurred in 1 case. Conclusion: Percutaneous vertebroplasty is effective in treatment of osteolytic metastatic vertebral body.