经皮椎体成形术治疗胸腰椎椎体恶性肿瘤的疗效分析

Percutaneous vertebroplasty for thoracic and lumbar malignant tumor

目的研究经皮椎体成形术对胸、腰椎椎体恶性肿瘤的临床效果。方法21例患者中，经皮椎体成形术治疗多发性骨髓瘤5例11椎和胸、腰椎椎体转移性肿瘤16例27椎。按WHO疼痛评分标准评估治疗后疼痛缓解程度。结果随访6—12个月，平均7．8个月，1例失访，其余20例术后24h疼痛完全缓解率为60％（12／20），部分缓解率为25％（5／20）；术后1周完全缓解率为75％（15／20），部分缓解率为15％（3／20），术后3个月1例因其他部位肿瘤死亡，1例疼痛症状加重；随访期末因其他部位肿瘤共死亡3例，2例疼痛症状加重。术后7例15椎发生骨水泥渗漏，但都未引起临床症状，无骨水泥毒性反应、肺栓塞、感染和神经损伤等并发症的发生。结论经皮椎体成形术是一种缓解胸、腰椎肿瘤症状较为有效的方法。

Objective To study the effect of percutaneous vertebroplasty （PVP） for thoracic and lumbar malignant tumor. Methods Eleven vertebras in 5 cases with multiple myeloma and 27 vertebras in 16 cases with thoracic and lumbar malignant tumors were treated with PVP. Results Twenty cases were followed up for 7.8 month on average （6 to 12 months）. In 24 hours after operation, the rate of pain complete remission （CR） was 60 % （12/20） and the rate of partial remission （PR） 25% （5/20）. One week after operation, the rate of CR was 75% （15/20）and the rate of PR was 15% （3/20）. Three months after operation, I case died of the original tumor and 1 case had relieved symptoms. At the end of follow-up, 3 cases died of the original tumor and 2 cases had more symptoms. Meanwhile, after the operation, bone cement leakage happened in 15 vertebras of 7 cases and no other complications such as lung embolism occurred. Conclusion PVP is an excellent method for pain remission of patients with thoracic and lumbar malignant tumors.