微波消融联合骨成形术治疗扁骨骨转移瘤的临床疗效

Microwave ablation combined with percutaneous osteoplasty for the treatment of flat bone metastases:analysis of its curative efficacy

目的评估微波消融联合骨成形术治疗扁骨骨转移瘤的安全性、有效性。方法收集2017年1月至2021年1月中山市人民医院采用微波消融联合骨成形术治疗顽固性疼痛的扁骨骨转移瘤16例,治疗前后定期评价疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数问卷表(ODI)、生活质量评价表(QOL)的变化及观察术后并发症。结果16例患者均手术成功,无严重术后并发症发生。术前、术后1 d、1周、1个月、3个月VAS评分分别为(7.4±0.9)、(7.3±0.9)、(2.0±0.9)、(1.3±0.8)、(1.6±0.5)分,ODI评分分别为(44.1±3.1)、(43.4±2.9)、(17.8±6.1)、(15.8±4.9)、(17.6±5.0)分;术前、术后1周、1个月、3个月QOL评分分别为(25.4±3.5)、(37.1±3.4)、(38.3±4.4)、(37.8±5.3)分。术后1周、1个月、3个月患者VAS评分(F=188.33,P<0.01)、ODI评分(F=114.86,P<0.01)均有下降,QOL评分在术后1周、1个月、3个月上升(F=31.51,P<0.01)。6例患者在术后3个月随访中术区局部出现肿瘤进展。结论微波消融联合骨成形术治疗扁骨骨转移瘤安全有效,可显著缓解患者疼痛,提高生活质量。

Objective To evaluate the safety and efficacy of microwave ablation(MWA)combined with percutaneous osteoplasty in treating flat bone metastases.Methods The clinical date of a total of 16 patients with refractory painful flat bone metastases,who received MWA combined with percutaneous osteoplasty at the Zhongshan Municipal People’s Hospital of China between January 2017 and January 2021,were retrospectively analyzed.The postoperative changes in visual analog scale(VAS)score,Oswestry disability index(ODI)score,quality of life assessment scale(QOL)score were evaluated.The complications were recorded.Results Successful operation was achieved in all the 16 patients,and no serious postoperative complications occurred.The preoperative,and postoperative 1-day,1-week,1-month and 3-month VAS scores were(7.4±0.9)points,(7.3±0.9)points,(2.0±0.9)points,(1.3±0.8)points and(1.6±0.5)points respectively.The preoperative,and postoperative 1-day,1-week,1-month and 3-month ODI scores were(44.1±3.1)points,(43.4±2.9)points(17.8±6.1)points,(15.8±4.9)points and(17.6±5.0)points respectively.The preoperative,and postoperative 1-week,1-month and 3-month QOL scores were(25.4±3.5)points,(37.1±3.4)points,(38.3±4.4)points and(37.8±5.3)points respectively.The postoperative 1-week,1-month and 3-month VAS scores(F=188.33,P<0.01),ODI scores(F=114.86,P<0.01)were decreased,while postoperative 1-week,1-month and 3-month QOL scores(F=31.51,P<0.01)were increased.Local tumor progression was observed in 6 patients during postoperative 3-month follow-up visit.Conclusion For flat bone metastases,MWA combined with percutaneous osteoplasty is a safe and effective treatment,which can significantly relieve pain and improve the quality of life of patients.