经皮椎体后凸成形术联合放射粒子植入治疗脊柱转移瘤

发布时间：2017-12-28 03:24

本文关键词：经皮椎体后凸成形术联合放射粒子植入治疗脊柱转移瘤　出处：《现代仪器与医疗》2016年06期 　论文类型：期刊论文

【摘要】：目的 :研究经皮椎体后凸成形术联合放射粒子植入治疗脊柱转移瘤的安全性和疗效。方法 :选取我院于2015年2月—2016年4月接收的106例需要进行手术治疗的中晚期脊柱转移瘤患者,随机并结合患者意愿分为联合放射组和PKP组。PKP组给予传统的经皮椎体后凸成形术治疗,联合放射组在经皮椎体后凸成形术的基础上联合~(125)Ⅰ粒子植入进行治疗。采用视觉模拟评分量表(VAS)及病变椎体高度恢复的程度来评估治疗后临床症状转归情况,同时检测患者治疗后的血清NTx、ICTP和BAP等指标表达水平,并于治疗后7天、1个月及6个月定期随访。结果 :所有纳入患者治疗过程顺利,两组患者治疗后7天、1个月及6个月随访记录的视觉模拟评分、椎体高度较治疗前显著改善(P0.05);且联合放射组患者VAS评分显著低于PKP组,差异有统计学意义(P0.05);两组患者之间椎体前后缘高度的增加幅度差异没有统计学意义。治疗后两组患者的血清NTx、ICTP和BAP水平均较治疗前显著性降低(P0.05),联合放射组患者血清NTx、ICTP和BAP水平显著低于PKP组(P0.05)。结论 :经皮椎体后凸成形术联合放射粒子~(125)Ⅰ植入治疗脊柱转移瘤不仅能有效恢复病变椎体的高度,而且能在迅速缓解肿瘤所致的疼痛的同时有效地抑制患者血清中NTx、ICTP和BAP的表达水平,提高患者的生活质量。
[Abstract]:Objective: To study the safety and efficacy of percutaneous kyphoplasty combined with radioactive particle implantation for the treatment of spinal metastases. Methods: 106 patients with advanced spinal metastases who received surgical treatment in our hospital from February 2015 to April 2016 were randomly divided into combined radiation group and PKP group. Group PKP was treated with traditional percutaneous kyphoplasty. Combined radiation group was treated with ~ (125) I seed implantation on the basis of percutaneous kyphoplasty. Visual analogue scale (VAS) and the degree of recovery of lesion vertebral height were used to evaluate the clinical symptoms after treatment. Meanwhile, the levels of serum NTx, ICTP and BAP were detected. The patients were followed up for 7 days, 1 months and 6 months after treatment. Results: all patients in the course of treatment is successful, the two groups of patients after treatment for 7 days, 1 months and 6 months follow-up recorded visual analogue score, vertebral height significantly improved compared with before treatment (P0.05); and combined with radiotherapy in patients with VAS score was significantly lower than that of PKP group, the difference was statistically significant (P0.05) between; two groups of patients with vertebral body height increase the magnitude of the difference was not statistically significant. After treatment, the serum levels of NTx, ICTP and BAP in the two groups were significantly lower than those before treatment (P0.05). The levels of serum NTx, ICTP and BAP in the combined radiation group were significantly lower than those in the PKP group (P0.05). Conclusion: percutaneous kyphoplasty combined with ~ (125) I radioactive particles implantation in the treatment of spinal metastases can effectively restore vertebral height, the expression level and can effectively inhibit the NTx, ICTP and BAP in serum of patients with the rapid relief of pain caused by tumor, improve the quality of life of patients.
【作者单位】：郑州大学附属肿瘤医院骨软组织科;
【分类号】：R738
【正文快照】： 恶性肿瘤晚期常发生骨转移,其中以椎体转移最为多见,椎体转移不仅使患者产生剧烈疼痛,而且瘤体迅速增长也会导致患者脊髓及神经被破坏,严重者导致患者椎体损坏而塌陷,甚至有可能引起瘫痪。经皮椎体成形术是椎体转移瘤的传统治疗方法之一[1-2]。125I是一种放射性粒子,植入后可

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