经皮骶骨成形术联合射频消融术治疗骶骨转移瘤的临床疗效

Clinical efficacy of combination therapy of percutaneous sacroplasty and radiofrequency ablation for the treatment of sacral metastases

目的评价经皮骶骨成形术(PSP)联合射频消融术(RFA)治疗骶骨转移瘤的临床疗效。方法2013年7月至2020年6月上海交通大学医学院附属第六人民医院治疗疼痛性骶骨转移96例,分为PSP联合RFA组35例,单纯PSP组61例。采用视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评估手术前后的疼痛和活动功能情况。结果PSP联合RFA组与单纯PSP组VAS评分比较,术后1个月为1.95比2.94,术后3个月为1.90比2.83,术后6个月为1.88比3.01,术后1年为2.00比2.91,差异均有统计学意义(均P<0.05)。两组ODI评分比较,术后1个月为32.53比37.97,术后3个月为30.15比37.03,术后6个月为29.34比37.12,术后1年为28.26比35.24,差异均有统计学意义(均P<0.05)。两组的总体疼痛缓解率为94.28%比75.41%,差异有统计学意义(P<0.05)。结论PSP联合RFA治疗疼痛性骶骨转移瘤具有较好的安全性和有效性,比单纯PSP能更好地缓解疼痛和改善活动功能。

Objective To evaluate the clinical efficacy of percutaneous sacroplasty(PSP)together with radiofrequency ablation(RFA)in the treatment of sacral metastases.Methods A total of 96 patients with painful sacral metastasis,who were treated at the Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University of China between July 2013 and June 2020,were enrolled in this study.The patients were divided into PSP plus RFA group(combination group,n=35)and simple PSP group(n=61).Visual analogue scale(VAS)and Oswestry disability index(ODI)were used to evaluate the pain degree and motor function of patients before and after operation.Results The comparison of the VAS scores between the combination group and the simple PSP group,the postoperative one-month value was 1.95 points vs.2.94 points,the postoperative 3-month value was 1.90 points vs.2.83 points,the postoperative 6-month value was 1.88 points vs.3.01 points,and the postoperative 12-month value was 2.00 points vs.2.91 points,and all the differences between the two groups were statistically significant(all P<0.05).The comparison of the ODI scores between the combination group and the simple PSP group,the postoperative one-month value was 32.53 points vs.37.97 points,the postoperative3-month value was 30.15 points vs.37.03 points,the postoperative 6-month value was 29.34 points vs.37.12points,and the postoperative 12-month value was 28.26 points vs.35.24 points,and all the differences between the two groups were statistically significant(all P<0.05).The overall pain relief rate in the combination group was 94.28%,which was 75.41%in the simple PSP group,the difference between the two groups was statistically significant(P<0.05).Conclusion For the treatment of painful sacral metastases,PSP plus RFA carries better safety and effectiveness,and it is superior to simple PSP in relieving pain degree and improving motor functions.(J Intervent Radiol,2022,31:1194-1197)