经皮椎体后凸成形术治疗多发性椎体转移瘤的疗效分析

Pereutaneous kyphoplasty in the therapy of multiple spinal metastases：evaluation of the therapeutic efficacy

目的 探讨经皮椎体后凸成形术治疗多发性椎体转移瘤的疗效.方法 回顾性分析18例多发性椎体转移瘤患者（共177节病变椎体）的临床资料,从中挑选出40节致痛椎体行经皮椎体后凸成形术（PKP）,PKP术后采用VAS评分、ECOG评分对患者的疼痛、功能状况进行评价,观察临床疗效.结果 患者术后6个月内各时间点VAS评分与术前比较差异均有统计学意义（P〈0.05）.术后1年与术前比较差异未见统计学意义（P〉0.05）.ECOG得分术后1d与术前相比差异未见统计学意义（P〉0.05）,术后1周、1个月、3个月与术前比较差异有统计学意义（P〈0.05）,术后6个月、1年与术前比较差异未见统计学意义（P〉0.05）.结论 对于能够确定致痛椎体的多发性椎体转移瘤,经皮椎体后凸成形术可以减轻疼痛,提高患者生活质量,近期疗效满意,但远期疗效不确定.

Objective To investigate the efficacy of pereutaneous kyphoplasty（PKP）on multiple vertebral metastases.Methods The clinical data of 18 patients with multiple vertebral metastases （totally 177 vertebral badies） were retrospectively analyzed,among whom 40 responsible vertebral bodies were treated by pereutaneous kyphoplasty（PKP）,according to Visual Analogue Scale （VAS）,Eastern Cooperative Oncology Group（ECOG） respectively to evaluate the pain,function situation after PKP in order to observe clinical efficacy of patients.Results Technical success was achieved in all 40 diseased vertebraes,compare each time point after the operation with preoperative VAS scores,VAS scores were significant （P 〈 0.05）.There was no significant difference between one year after operation and preoperative VAS scores （P 〉 0.05）.There was no significant difference between one day after operation and preoperative ECOG score （P 〉 0.05）.These differences were significant between one week after operation,one month after operation,three months after operation and preoperative ECOG score （P 〈 0.05）.These differences were not significant between six months after operation,one year after operation and preoperative ECOG score（P 〉 0.05）.Conclusions For multiple vertebral metastases,if you can determine the responsible vertebral body,PKP can reduce pain,improve the quality of life of patients,the short-term efficacy is satisfactory,but the long-term efficacy is not determined.