椎体转移瘤患者碘125粒子内放疗联合经皮椎体成形术后疼痛缓解时间的影响因素分析

Analysis of influencing factors of postoperative pain relief time after 125 iodine internal radiotherapy combined with percutaneous vertebroplasty in patients with vertebral metastases

目的近年来有研究将经皮椎体成形术(PVP)联合碘125(I125)粒子植入用于脊柱转移瘤的治疗。文中探讨椎体转移瘤患者I125粒子内放疗联合PVP后疼痛缓解时间的影响因素。方法回顾性分析2017年1月至2019年5月期间于甘肃省第二人民医院经I125粒子内放疗联合PVP治疗的220例椎体转移瘤患者临床及术后3个月、6个月的临床随访资料。观察患者I125粒子内放疗联合PVP后VAS评分、疼痛缓解率及缓解时间,并采用Cox回归分析方法确定影响疼痛缓解时间的危险因素。结果治疗前患者VAS评分为(8.25±1.06)分,治疗后3个月时下降至(4.03±1.12)分,治疗6个月时下降至(1.14±0.03)分,差异有统计学意义(P=0.000)。治疗后患者疼痛缓解总有效率3个月时为89.09%(196/220),6个月时上升为99.09(218/220),差异有统计学意义(P=0.000)。Cox回归分析结果显示,影响疼痛缓解时间的危险因素主要为疼痛缓解程度(P=0.001)和出现疼痛至接受放疗的间隔时间(P=0.011)。结论椎体转移瘤患者采用PVP和I125粒子植入联合治疗后可有效缓解患者疼痛;且疼痛缓解时间受疼痛缓解程度和疼痛出现时间至放疗间隔时间的影响,应引起临床重视。

Objective It has been reported that percutaneous vertebroplasty(PV P)combined with iodine 125(I 125)seed implantation was treated for spinal metastases.This study aims to investigate the factors affecting the pain relief time of patients with vertebral metastasis I^125 intra-particle radiotherapy combined with PVP.Methods Retrospective analysis of 220 patients with vertebral metastases treated with I^125 intra-particle radiotherapy combined with PVP at the Second People's Hospital of Gansu Province from January 2017 to May 2019.The clinical follow-up data were collected at 3 and 6 months after surgery.To observe the VAS before and after the treatment,pain relief rate and time of elderly patients with vertebral metastases treated with I^125 combined with PVP,and use Cox regression analysis to determine the risk factors that affect pain relief time.Results The VAS score of patients before treatment was(8.25±1.06)points,which dropped to(4.03±1.12)points at 3 months after treatment,and fell to(1.14±0.03)points,the difference was statistically significant(P=0.000).After treatment,the total effective rate of pain relief was 89.09%(196/220)at 3 months and 99.09(218/220)at 6 months.The difference was statistically significant(P=0.000).The results of Cox regression analysis showed that the main risk factors affecting the time of pain relief were the degree of pain relief(P=0.001)and the time between the onset of pain and receiving radiotherapy(P=0.011).Conclusion The combined treatment of PVP and I^125 seed implantation in patients with vertebral metastasis can effectively relieve the patient's pain;and the time of pain relief is affected by the degree of pain relief and the time of pain appearing to the interval between radiotherapy,which should arouse clinical attention.