CT引导的PVP技术对椎体恶性肿瘤的治疗价值

Value of CT-guided percutaneous vertebroplasty for vertebral malignant tumors

目的探讨CT引导的经皮椎体成形术(PVP)对椎体恶性肿瘤的治疗价值。方法 CT引导下对56例椎体恶性肿瘤患者的92个病变椎体进行经皮穿刺,进入病变椎体后采集病理标本并注入骨水泥。对术前和术后不同时间段分别进行疼痛视觉模拟评分(VAS)、活动能力评分和使用止痛药物评分,并对评价结果进行统计学分析。结果 56例患者手术成功率为100%,无严重并发症,术后随访3-24个月,所有病变椎体影像学检查均未见肿瘤复发和椎体塌陷。VAS评分、活动能力评分和使用止痛药物评分术后1-3 d,术后1-2周和术后3个月较术前明显降低(P<0.05)。结论 CT引导的PVP技术能有效缓解椎体恶性肿瘤造成的疼痛,增加椎体稳定性,改善运动功能,是一种安全、微创、有效的治疗方法,并且较C型臂透视机引导更具优势。

Objective To explore the value of CT-guided percutaneous vertebroplasty（PVP）in treatment of vertebral malignant tumors.Methods CT-guided PVP was used to treat 92 vertebral lesions of 56 patients with vertebral malignant tumors.Pathological specimens were collected and the bone cement was injected into the vertebral.Visual analogue scale（VAS）,activity of daily living scale and scale for analgesic drugs were observed before and after surgery.Results The successful rate was 100%.No serious complications occurred.After all the patients were followed up for 3-24 months,tumor recurrence and vertebral collapse were not found in all lesions of the vertebral by medical imaging examinations.Visual analogue scale（VAS）,activity of daily living scale and scale for analgesic drugs gradually decreased 1-3 days after surgery,1-2 weeks after surgery,and 3 months after surgery（P〈0.05）.Conclusion CT-guided percutaneous vertebroplasty for vertebral malignant tumors can effectively relieve the pain,increase the stability,and improve the motor function.It is a safe,minimally invasive,effective treatment method,and has more advantages than C-arm fluoroscopy guidance.