摘要
目的探讨射频消融（RFA）联合经皮椎体成形术（PVP）治疗脊柱转移瘤的临床疗效与安全性。方法分析2009年6月至2011年6月于无锡市第四人民医院及上海市第六人民医院行RFA联合PVP或单纯PVP治疗脊柱转移瘤362例，选择其中具有完整资料的226例为研究对象．其中RFA联合PVP组（A组）105例，153节椎体；单纯PVP组（B组）121例，190节椎体。比较患者疼痛缓解情况，采用配对t检验对所得数据进行统计学分析。比较两组骨水泥的外漏率、外漏类型，采用R×C列联表x^2检验进行统计学分析。结果疼痛缓解根据WHO标准，A组术后1d、1周、1个月、3个月的有效率为分别为83．8％、86．9％、87．2％和82．2％；B组同期有效率分别为81．0％、83．6％、84．1％和80．5％，经配对t检验，术后随访时间段两组患者疼痛均得到明显缓解（P〈0．05），两组间疗效差异无统计学意义（P〉0．05）。A组和B组骨水泥外漏发生率分别为17．6％和37．4％，采用C列联表x^2检验，差异有统计学意义（P〈0．05）；A组未出现神经根压迫症状，B组有3例患者出现神经根压迫症状，用激素、脱水、止痛对症治疗后好转。结论RFA联合PVP与单纯PVP治疗脊柱转移瘤均具有良好的止痛效果．两组术后疗效对比分析差异无统计学意义；A组骨水泥外漏少于B组，PVP之前行RFA可减少骨水泥外渗。
Objective To assess the clinical effectiveness and safety of radiofrequency ablation （RFA） combined with percutaneous vertebroplasty （PVP） therapy for the treatment of spinal metastases. Methods During the period from June 2009 to June 2011 a total of 362 consecutive patients with spinal metastases were treated with either combination use of RFA and PVP or simple PVP in Wuxi 4th People＇s Hospital or in Shanghai 6th People＇s Hospital. A total of 226 cases who had complete medical information were enrolled in this study. Combination group （n = 105） received RFA and PVP treatment and 153 diseased vertebral bodies were detected in this group. Simple PVP group （n = 121） received PVP treatment only and 190 diseased vertebral bodies were found in this group. The pain remission rates of the two groups were regularly evaluated according to the criterion of WHO, and the data were analyzed by using paired-samples t test. The bone cement leakage rates and the leakage patterns of the two groups were statistically analyzed by using Cbi-square test. Results The pain remission rates in combination group at one day, one week, one and 3 months after the therapy were 83.8%, 86.9%, 87.2% and 82.2% respectively, which were 81.0%, 83.6%, 84.1% and 80.5% respectively in simple PVP group. Significant pain relief was obtained in all patients of both groups （P 〈 0.05）, while the difference in pain remission rate between the two groups was not significant （P 〉 0.05）. The frequency of bone cement leakage in combination group and in simple PVP group was 17.6% and 37.4% respectively, and the difference between the two groups was statistically significant （P 〈 0.05）. Three patients in simple PVP group developed symptoms of nerve root compression, which were improved after the symptomatic medications such as hormones, dehydration, analgesics, etc. No symptoms of nerve root compression occurred in combination group. Conclusion Both combination use of RFA together with PVP and simple use of PVP have excellent anti-pain effect for patients with spinal metastases. No significant difference in therapeutic effect exists between the two therapies. The occurrence of bone cement leakage in combination group is less than that in simple PVP group, therefore, use of RFA before PVP can reduce the occurrence of bone cement leakage. （J Intervent Radiol, 2012, 21： 747-751）
出处
《介入放射学杂志》
CSCD
北大核心
2012年第9期747-751,共5页
Journal of Interventional Radiology
关键词
脊柱转移瘤
射频消融术
经皮椎体成形术
骨水泥外漏
spinal metastasis
radiofrequency ablation
percutaneous vertebroplasty
bone cement leakage
