经皮后凸成形术联合射频消融术治疗脊柱转移性肿瘤的疗效观察

Efficacy of percutaneous kyphoplasty combined with radiofrequency ablation in the treatment of metastatic spinal tumors

目的 探讨经皮后凸成形术(PKP)联合射频消融术(RFA)治疗脊柱转移性肿瘤的疗效及对基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)和C反应蛋白(CRP)水平的影响,为临床研究提供指导。方法 选取2016年10月至2021年10月间陕西省森林工业职工医院收治的70例脊柱转移性肿瘤患者进行研究,采用随机数表法分为观察组和对照组,每组35例。对照组给予PKP治疗,观察组给予PKP联合RFA治疗。观察并比较两组患者临床治疗效果、视觉模拟疼痛(VAS)评分情况以及MMP-2、MMP-9和CRP水平变化情况。结果 术后,观察组治疗总有效率为94.3%,高于对照组的74.3%,差异有统计学意义(P<0.05)。术后1d、7d、3个月、6个月,两组患者VAS评分均较术前下降,且术后1d、6个月VAS评分观察组均低于对照组,差异均有统计学意义(均P<0.05)。术后,两组患者MMP-2、MMP-9和CRP水平均较术前下降,且观察组水平较对照组更低,差异均有统计学意义(均P<0.05)。结论 PKP联合RFA治疗脊柱转移性肿瘤的疗效较好,不仅能缓解患者疼痛情况,改善脊髓功能,还能降低机体炎性反应,值得临床推广应用。

Objective To study the efficacy of percutaneous kyphoplasty(PKP) combined with radiofrequency ablation(RFA) in the treatment of spinal metastatic tumors and its effects on matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9) and C-reactive protein(CRP). Methods Seventy patients with metastatic spinal tumors were selected at Shaanxi Forest Industry Staff Hospital from October 2016 to October 2021. They were randomly divided into an observation group and a control group with 35 patients in each group. The observation group underwent PKP combined with RFA and the control group underwent PKP. The clinical treatment effects, visual analogue scale(VAS) and changes in the levels of MMP-2, MMP-9 and CRP were observed and compared between the two groups. Results After the operation, the overall efficacy rate was 94.3% in the observation group which was significantly higher than 74.3% of the control group(P<0.05). The VAS scores decreased after the operation compared with those before the operation and they were significantly lower in the observation group than those in the control group at 1 d, 7 d, 3 months and 6 months after the operation(all P<0.05). After the operation, the levels of MMP-2, MMP-9 and CRP decreased in the two groups compared with those before the operation and the levels were significantly lower in the observation group than those in the control group(all P<0.05). Conclusion PKP combined with RFA is effective in the treatment of spinal metastatic tumors. It not only can significantly alleviate the pain and improve spinal cord function, but also reduce the inflammatory response. It is worthy of clinical application.