摘要
目的探讨经皮椎体后凸成形术（PKP）治疗胸腰段骨髓瘤引起的椎体压缩性骨折的患者疼痛及日常活动改善情况。方法选择2010年9月~2012年10月28例胸腰段骨髓瘤患者,其中男性21例,女性7例;年龄52~72岁,平均年龄61.2岁;病程6~20个月,平均病程10.6个月。均采用在C型臂下行椎弓根穿刺球囊扩张椎体后注射骨水泥治疗,采用疼痛视觉模拟评分（VAS）、活动能力评分（KPS）于术后24 h、1个月、12个月评估疼痛缓解及日常活动功能恢复情况。结果 28例患者术后24 h内疼痛均缓解,无一例出现脊髓或神经根损伤及压迫症状,复查X射线片见椎体内骨水泥填充良好。手术前后VAS差异有统计学意义（P〈0.05）;术后随访12个月疼痛缓解及日常活动功能改善趋于稳定;术后24 h、1个月、12个月疼痛缓解率分别为75.00%（21/28）、92.86%（26/28）及82.14%（23/28）;所有病例未见椎体进一步压缩、疼痛无明显加重等并发症发生。结论 PKP治疗脊柱胸腰段多发性骨髓瘤具有微创、手术时间短、止痛效果好等优点,是一种安全、有效的手术方式,可以恢复椎体高度,加强椎体强度,重建脊柱稳定性,提高患者生活质量,值得临床推广应用。
Objective To evaluate the pain relief and daily activities in patients with myeloma induced thoracolumbar vertebral compression fractures by percutaneous kyphoplasty（PKP）. Methods A total of 28 cases with myeloma induced thoracolumbar vertebral compression fractures were enrolled, which included 21 males and 7 females, aged 52 - 72 years old with mean age of 61.2. The duration was 6 - 20 months with mean duration of 10.6 months. Percutaneous balloon dilatation of pediculus areus vertebra was performed under C-arm X-ray guidance and the created cavity was filled with bone cement. The visual analogue scales（VAS）, Karnofsky performance scales（KPS） after the procedure were recorded, and follow-up of 24 hours post-operation, 1 month and 12 months were analyzed. Results The 28 cases were performed successfully without conspicuous pain relief and spinal injury or compression, and X-ray analysis showed the vertebrates treated with cement were filled well. The VAS score before and after operation was significantly different（P 〈 0.05）. The follow-up of pain relief and functional improvement at 12 months post-operation was stable. The rate of pain relief at 24-hour, 1- month and 12-month was 75.00 %（21/28）, 92.86 %（26/28） and 82.14 %（23/ 28）, respectively. None of complications of vertebral compression and serious pain occurred. Conclusion It is demonstrated that PKP is minimally invasive, time saving and effective for pain relief. It is a safe and effective way in treatment of myeloma induced thoracolumbar vertebral compression fractures. It could recover height of abnormal vertebra, strengthen and reconstruct vertebral, improve quality of life for patients, so it is worthy of clinical application.
出处
《生物医学工程与临床》
CAS
2015年第1期22-26,共5页
Biomedical Engineering and Clinical Medicine
