多发性骨髓瘤骨病的手术治疗效果及预后的相关因素分析

Analysis of the Surgical Treatment Effect and Prognosis of Multiple Myeloma Bone Disease

目的分析多发性骨髓瘤骨病(MMBD)的手术治疗效果及预后的相关因素。方法回顾性分析114例MMBD患者临床资料。114例MMBD患者均采用手术治疗,术后随访24个月,记录患者的一般资料及实验室检查结果、化疗治疗情况。分析手术治疗效果以及影响患者预后的相关因素。结果患者术后美国东部肿瘤协作组(ECOG)评分[(1.89±0.35)分]、视觉模拟评分法(VAS)评分[(5.03±0.84)分]低于术前,美国肌骨骼肿瘤协会(MSTS)评分[(22.09±3.04)分]高于术前,差异有统计学意义(P<0.05)。114例患者术后出现并发症10例,并发症发生率为8.77%(10/114)。术后随访24年,114例患者中生存93例,死亡21,生存率为81.58%(93/114);病理骨折、乳酸脱氢酶(LDH)≥150 IU/L、化疗与患者预后有关(P<0.05);年龄、性别、病程、肌酐(Cr)、白蛋白(Alb)、C反应蛋白(CRP)与患者预后无关(P>0.05);Logistic回归分析显示,病理骨折、LDH、化疗是影响患者预后的危险因素(P<0.05且OR≥1)。结论MMBD的手术治疗效果良好,有利于缓解患者疼痛,改善体力状况,而病理骨折、LDH、化疗是影响MMBD患者预后的危险因素,临床应加以重视。

Objective To analyze the surgical treatment efficacy and prognostic factors of multiple myeloma bone disease(MMBD).Methods Clinical data of 114 MMBD patients were analyzed retrospectively.All the 114 patients with MMBD were treated with surgery and were followed up for 24 months.Their general data,laboratory examination results and chemotherapy treatment were recorded.The effect of surgical treatment was analyzed,and related factors affecting patient outcomes.Results The postoperative Eastern American Cooperative Oncology Group(ECOG)score[(1.89±0.35)score],visual simulation scoring method(VAS)score[(5.03±0.84)score]was lower than before surgery,The American Association of Myobloskeletal Oncology(MSTS)score[(22.09±3.04)score]was higher than in the preoperative score,The difference was statistical significant(P<0.05);In 114 patients,10 patients had postoperative complications,The incidence of complications was 8.77%(10/114);She was followed up for 24 years later,Of the 114 patients,93 patients survived,Death:21,Survival rate was 81.58%(93/114);Pathological fractures,lactate dehydrogenase(LDH)150 IU/L,and chemotherapy are associated with patient prognosis,The difference was statistical significant(P<0.05);Age,sex,disease course,creatinine(Cr),albumin(Alb),and C-reactive protein(CRP)were not associated with patient prognosis,The difference was not significantly significant(P>0.05);The Logistic regression analysis showed that,Pathological fractures,LDH,and chemotherapy are the risk factors affecting the patient prognosis(P<0.05 and OR 1).Conclusion MMBD is beneficial to relieve pain and improve physical condition,and pathological fracture,LDH and chemotherapy are risk factors in MMBD patients,which should be considered clinically.