经皮椎体成形术治疗椎体转移癌22例疗效观察

Percutaneous Vertebroplasty for Vertebral Metastatic Carcinoma:Curative Effect Observation of 22 Cases

目的观察经皮椎体成形术(PVP)治疗椎体原发或转移癌在控瘤增殖、缓解疼痛、强化加固椎体机械应力以及患者生活质量、生存期等方面的临床效果和意义。方法在C型臂X光机引导下,经皮椎体穿刺,注入骨水泥和抗癌药。回顾性与随机对照组对比综合分析。结果本组22例24次共治疗43椎体,术后10日,疼痛完全缓解;术后1个月内,治疗组22例均不需依赖镇痛药,疼痛缓解率100%,无效者为0。随访4～36个月,22例43椎体未发现经治椎体肿瘤复发进展,未发现经治椎体被压缩骨折而损伤脊髓致瘫痪者,16例生活自理,占72.6%(16/22);6例卧床率为27.2%(6/22),1年生存率50%(11/22),2年生存率18.2%(4/22),其中2例接近30个月,1例术后已生存36个月,现仍能参加家庭生活劳动。结论 PVP是目前治疗椎体转移癌的较好方法。

Objective To observe the clinical effectiveness and significance of percutaneous vertebroplasty（PVP） for vertebral primary or metastatic cancer in the control of tumor proliferation, pain ease, strengthening the reinforced vertebral mechanical stress, and patients＇ quality of life, survival and other aspects. Methods In the C-arm X-ray guidance,percutaneous vertebral puncture and injection of bone cement and anti-cancer drugs were carried out. A retrospective comparison with the random control group, comprehensive analysis and statistical analysis were made. Results The treatment group including 22 patients with 43 vertebrae was treated 24 times. 10 days after surgery,there was complete pain relief in 22 cases, one month after surgery 22 cases in the treatment group were not dependent on pain medicine, with pain relief rate of 100% and no ineffective case. 4 to 36 month foUow-up showed no vertebral tumor recurrence and no compressed vertebral fracture leading to the spinal cord damage and paralysis. And self-care ability accounted for 72.6%（16/22） ;bed rate 27.2%（6/22）, 1 year survival rate 50% （11/22）and 2-year survival rate 1B.2% （4/22）, of which 2 cases reached nearly 30-month survival and one case 36-month survival, able to participate in homework. Conclusion PVP is a good method for vertebral metastatic carcinoma.