经皮骨成形术治疗髋臼骨转移瘤

Percutaneous osteoplasty for the treatment of acetabular bone metastases

目的:探讨骨成形术治疗髋臼骨转移瘤。方法 :回顾性分析12例髋臼骨转移瘤骨成形术治疗的方法、效疗及并发症。结果:手术成功率100%;术后1周,疼痛缓解总有效率100%,疼痛评分降至(4.1±2.1)分;术后1、3、6月疼痛评分平均(3.1±1.2)分、(2.0±1.4)分、(1.8±1.7)分。术前与术后24 h及1周、1月、3月与前一随访期评分有显著差异(P均<0.05),术后3月与6月无明显差异(P=0.241)。行走功能评分:术前评分平均为(0.75±0.72)分、术后1周评分平均为(1.9±0.5)分(P=0.0249),术后1、3、6月评分平均为(2.5±0.63)分、(2.7±0.71)分、(3.0±0.5)分,术后1、3、6月行走评分间无显著差异(P均>0.05)。能有效停止、减量、降级使用镇痛剂。1例发生双下肢血栓性静脉炎。结论:骨成形术治疗髋臼转移瘤,操作简单、安全性较高、疗效肯定,能有效缓解疼痛、改善关节功能,可以提升患者的生存质量。

Objective： To explore the treatment of acetabular bone metastases by osteoplasty. Methods： The treatment methods, therapeutic effect and complications of osteoplasty of 12 cases with acetabular bone metastases were retrospectively analyzed. Result： The success rate of operation was 100%. The total effective rate of pain relief attained to 100% and the score of pain dropped to （4.1±2.1） at 1 week after operation. The average score of pain was （3.1±1.2）, （2.0±1.4）, （1.8±1.7） respectively at 1 month, 3 months and 6 months after operation. There were significant differences in the score of pain between preoperative and postoperative 24 hours, postoperative 1 week and 1 month and postoperative 1 month and 3 months （P〈0.05）. There was no significant difference in the score of pain between postoperative 3 months and 6 months （P=0.241）. The average score of ability to walk was（0.75±0.72） and （1.9±0.5） at preoperation and 1 week after operation. The average score of ability to walk was （2.5±0.63）, （2.7±0.71）, （3.0±0.5） at 1 month, 3 months and 6 months after operation, respectively, and there was no significantly different among them （P〉0.05）. It could effectively stop, reduce and downgrade the use of analgesics. One case was with both lower limbs thrombophlebitis. Conclusion： Osteoplasty is easy to operate and fine security performance, has certain effect to treat acetabular metastases, and which can relieve pain, improve the function of joints and the quality of living.