经皮椎体成形术联合微波消融术治疗多发性骨髓瘤致胸腰椎病理性骨折的效果及安全性

Effect and safety of percutaneous vertebroplasty combined with microwave ablation in the treatment of thoracolumbar pathological fractures caused by multiple myeloma

目的探讨经皮椎体成形术联合微波消融术治疗多发性骨髓瘤致胸腰椎病理性骨折的效果及安全性。方法根据治疗方法的不同将60例多发性骨髓瘤致胸腰椎病理性骨折患者分为对照组(n=33)和观察组(n=27),对照组患者进行单纯经皮椎体成形术,观察组患者进行经皮椎体成形术联合微波消融术。比较两组患者的视觉模拟评分法(VAS)评分、Barthel指数评分、病变椎体高度、治疗有效率及术后并发症发生情况。结果手术后,观察组患者的VAS评分明显低于对照组,Barthel指数评分明显高于对照组,差异均有统计学意义(P﹤0.01)。手术后,观察组患者的病变椎体前缘高度、中部高度均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的治疗有效率高于对照组(P﹤0.05)。两组患者的并发症总发生率比较,差异无统计学意义(P﹥0.05)。结论对多发性骨髓瘤致胸腰椎病理性骨折患者进行经皮椎体成形术联合微波消融术治疗,有利于降低患者疼痛程度,提高患者的日常生活活动能力及病变椎体高度,具有较好的治疗效果,且不会增加手术并发症。

Objective To investigate the effect and safety of percutaneous vertebroplasty combined with microwave ablation in the treatment of thoracolumbar pathological fractures caused by multiple myeloma.Method A total of 60 patients with thoracolumbar pathological fractures caused by multiple myeloma were divided into control group(n=33)and observation group(n=27)according to different treatment methods.The patients in the control group underwent simple percutaneous vertebroplasty,while patients in the observation group underwent percutaneous vertebroplasty combined with microwave ablation.The visual analogue scale(VAS)score,Barthel index score,the height of the lesioned vertebral body,treatment response rate,and postoperative complications were compared between the two groups.Result After the surgery,the VAS score of the observation group was lower than that of the control group,and the Barthel index score was higher than that of the control group,the differences were statistically significant(P<0.01).After the surgery,the anterior and middle heights of the lesioned vertebral body in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The treatment response rate of the observation group was higher than that of the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Percutaneous vertebroplasty combined with microwave ablation for patients with thoracolumbar pathological fractures caused by multiple myeloma is beneficial to reduce the pain degree of the patients,improve the activities of daily living and the height of the lesioned vertebral body.In addition,the therapy has a good therapeutic effect without increasing the risk of surgical complications.