经皮穿刺骨水泥注入治疗溶骨性转移瘤的临床疗效分析

Clinical effect of bone cement by percutaneous puncture for the treatment of orosteolytic carcinoma

目的探讨DSA引导下经皮穿刺骨水泥注入治疗不同部位骨转移瘤的相关技术及临床疗效。方法根据CT的扫描图像和定位图像,了解病变区的穿刺角度及生理曲度,确定DSA的旋转角度,在DSA引导下持穿刺针送入病变区并注入骨水泥,观察术后疗效。结果本组63例患者,脊柱转移瘤45例计72个椎体,四肢长骨转移瘤15例,不规则骨转移瘤3例。所有部位全部穿刺成功,术后疼痛症状均有明显缓解、止痛总有效率为(53/63)84.1%,脊柱转移瘤患者有效率(37/45)82.2%,四肢长管骨患者有效率为(14/15)93.3%,不规则骨患者有效率(2/3)66.7%。结论经皮穿刺骨水泥注入治疗脊椎、四肢长管状骨溶骨性转移瘤效果显著,随着手术方法不断成熟,适应症将不断扩大,该技术将成为脊柱、四肢长骨转移瘤有效治疗方法。

Objective To investigate the related technology and clinical effect of bone cement by percutaneous puncture under DSA guided for the treatment of metastatic tumors of bones. Methods The puncture direction and the angle of rotation of DSA was made according to the images of CT, then bone cement were perfused to the bone with pathological changes through percutaneous puncture under CT or C-arm X-ray machine guided. The clinical effect was evaluated in follow up. Results There were 63 cases including 45 cases with metastatic tumors of vertebral column （72 vertebras）, 15 cases with metastatic tumors of long bones and 3 cases with metastatic tumors of irregular bones. The procedure was successful in all patients, and the symptoms in all cases were remarkably relieved, the total effective rate was 84.1%（53/63）, the effective rate of patients with metastatic tumors of vertebral column was 82.2%（37/45）, the effective rate of patients with metastatic tumors of long bones was 93.3%（14/15）, the effective rate of padents with metastatic tumors of irregular bones was 66.7%（2/3）. Conclusion The effect of bone cement by percutaneous puncture for the treatment of orosteolytic carcinoma of vertebral column and long bones is remarkable and this technology will be effective in treatment of metastatic tumors of vertebral column and long bones.