椎体硬化成型和切除术治疗脊柱转移瘤的临床疗效对比分析

Clinical analysis of vertebral sclerosis angioplasty and resection for the treatment of spinal metastases

目的:探讨椎体硬化成型术和切除术对脊柱转移瘤的治疗效果。方法:回顾性分析2008-10-04-2012-01-16入住我院并接受治疗的脊柱转移瘤患者150例,其中75例经过CT、X射线检查存在皮质断裂缺失、椎体变形、虫蚀样破坏、溶骨性破坏和附件结构不清的患者行姑息肿瘤刮除术联合椎体硬化成型术(联合组),75例无骨组织明显变形破坏但为恶性肿瘤转移患者行转移瘤切除术(切除术组)。术后1、3、6、9和12个月对两组患者的疼痛进行VAS评分。同时术后3个月对两组患者进行满意度调查及疾病情况复查。结果:联合组75例患者中,生存患者74例,死亡1例,中位生存时间为302.1d。切除术组75例患者中,生存患者72例,死亡3例,中位生存时间为242.9d。联合组和切除术组术后1个月患者疼痛指数分别为8.26±1.11和8.41±1.01;3个月分别为7.39±1.10和7.43±1.12;6个月分别为4.01±1.11和7.32±1.13;9个月分别为3.51±1.05和6.40±1.02;12个月分别为2.51±1.06和6.14±1.21。6、9和12个月患者疼痛指数差异有统计学意义,P<0.05。切除术组满意度为92.0%(69/75),联合组为98.7%(74/75),差异无统计学意义,P>0.05。结论:两种术式效果类似,但姑息肿瘤刮除术联合椎体硬化成型术创伤小、恢复快,值得进一步深入研究。

OBJECTIVE：To investigate the therapeutic effect of vertebral sclerosis angioplasty surgery on spinal me- tastases. METHODS：Totally 150 spinal metastases patients from 10-04-2008 to 01-16-2012 were selectel,all patients were randomly divided into two groups, respectively resection and combined groups, each group of 75 patients. The resection Group was trealed with resection,and the combination group was treated with palliative surgery vertebral joint sclerosis angioplasty treatment. And 1,3,6,9,12 months after surgery, the pain of patients, pain scores, VAS scores were detected. Satisfaction of Survey and the patients＇ condition were reviewed three months later. RESULTS：In the combination group, 74 patients survived,1 patient died. The median survival time was 302.1 days. In the resection group, 72 patients sur- vived,3 patients died,and the median survival ＇time was 242.9 days. The pain index of combination group and resection group were 8.26±1.11 and 8.41±1.01 one month after operation,7. 39±1.10 and 7. 43±1.12 three months after oper- ation,4. 01±1.11 and 7.32±1.13 six months after operation,3.51±1.05 and 6.40±.02 nine months after operation, 2.51± 1.06 and 6.14_q-1.21 twelve months after operation. The pain index of 6, 9 and 12 months were significantly dif- ferent,P±0. 05, The satisfaction of resection group and combination group were 92.0± （69/75） and 98.7± （74/75）, with no significant difference,P±0.05. CONCLUSION：The treatment effect of vertebral sclerosis angioplasty was similar to that of resection, with less injury and quicker recover.